Provider Demographics
NPI:1992782593
Name:REYNA, ANA (MD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANA REYNA MD
Other - Middle Name:A PROFESSIONAL
Other - Last Name:CORPORATION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2029
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303
Mailing Address - Country:US
Mailing Address - Phone:661-822-3519
Mailing Address - Fax:661-822-3528
Practice Address - Street 1:20111 WEST VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93516
Practice Address - Country:US
Practice Address - Phone:661-822-3519
Practice Address - Fax:661-822-3528
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G515580Medicaid
CA00G515580Medicaid
A52025Medicare UPIN