Provider Demographics
NPI:1558259952
Name:REYES SOTO, JOSE IVAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:IVAN
Last Name:REYES SOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 N ALVERNON WAY, TUCSON, AZ 85712
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:787-456-7817
Mailing Address - Fax:
Practice Address - Street 1:2732 N ALVERNON WAY, TUCSON, AZ 85712
Practice Address - Street 2:APT 170
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:787-456-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program