Individual provider Active NPI

Reese Eugene Polesky, MD

  • Orthopaedic Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1396797205
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G6438 Issued in CA
Practice address
703 N Camden Dr
Beverly Hills, CA 90210-3204
Phone
(310) 273-1786
Fax
(310) 858-7680
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G6438 CA Primary

Addresses

Primary practice location

703 N Camden Dr
Beverly Hills, CA 90210-3204

Mailing address

703 N Camden Dr
Beverly Hills, CA 90210-3204
Phone (310) 273-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G6438CAMDOrthopaedic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1396797205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N CAMDEN DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103204",
            "telephone_number": "310-273-1786",
            "fax_number": "310-858-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N CAMDEN DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103204",
            "telephone_number": "310-273-1786",
            "fax_number": "310-858-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLESKY",
        "first_name": "REESE",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G6438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.