Provider Demographics
NPI:1962541805
Name:REINER, ANGELEE KRUGER (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELEE
Middle Name:KRUGER
Last Name:REINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELEE
Other - Middle Name:KRISTIN
Other - Last Name:KRUGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:212
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356
Mailing Address - Country:US
Mailing Address - Phone:818-996-9677
Mailing Address - Fax:818-996-9709
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:212
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-996-9677
Practice Address - Fax:818-996-9709
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78096208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics