Individual provider Active NPI

Maria Lourdes Fernandez Reyes, MD, MPH

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
National Provider Identifier
1437340445
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A49139 Issued in CA
Practice address
6371 Rancho Mission Rd
Unit 2
San Diego, CA 92108-2016
Phone
(619) 988-2210
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A49139 CA Primary

Addresses

Primary practice location

6371 Rancho Mission Rd
Unit 2
San Diego, CA 92108-2016

Mailing address

PO Box 1592
La Jolla, CA 92038-1592
Phone (619) 988-2210

Other identifiers 1

IdentifierTypeStateIssuer
A49139OtherCACALIFORNIA LICENSE

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A49139CAMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1437340445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1592",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920381592",
            "telephone_number": "619-988-2210",
            "fax_number": "619-280-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6371 RANCHO MISSION RD",
            "address_2": "UNIT 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082016",
            "telephone_number": "619-988-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MARIA LOURDES",
        "middle_name": "FERNANDEZ",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A49139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "A49139",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.