Active NPI
Edmond Chan Reyes, INDEPENDENT CORPSMAN
- Military Health Care Provider
- Sandiego, CA
National Provider Identifier
1659449221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- Naval Air Station North Island
BLDG 290
Sandiego, CA 92135 - Phone
- (619) 767-1496
- Fax
- (619) 767-1497
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | CA | Primary |
Addresses
Primary practice location
Naval Air Station North Island
BLDG 290
Sandiego, CA 92135
Mailing address
35755 Coral Dr
Winchester, CA 92596
Phone (951) 852-8530
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659449221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35755 CORAL DR",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "92596",
"telephone_number": "951-852-8530",
"fax_number": "619-767-1497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL AIR STATION NORTH ISLAND",
"address_2": "BLDG 290",
"city": "SANDIEGO",
"state": "CA",
"postal_code": "92135",
"telephone_number": "619-767-1496",
"fax_number": "619-767-1497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "EDMOND",
"middle_name": "CHAN",
"name_prefix": "Mr.",
"credential": "INDEPENDENT CORPSMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandiego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.