Active NPI
Teresa Reynoso, M.D.
- Pediatric Adolescent Medicine Physician
- Menifee, CA
National Provider Identifier
1720057425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- MD13280
- Practice address
- 26900 Newport Rd
Suite 107
Menifee, CA 92584-9222 - Phone
- (951) 301-5380
- Fax
- (951) 301-5390
- NPI assigned
- Mar 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | MD13280 | HI | Primary |
Addresses
Primary practice location
26900 Newport Rd
Suite 107
Menifee, CA 92584-9222
Mailing address
27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661
Phone (951) 252-8582
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD13280 | HI | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1720057425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE",
"address_2": "SUITE 300",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902661",
"telephone_number": "951-252-8582",
"fax_number": "951-252-8589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26900 NEWPORT RD",
"address_2": "SUITE 107",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925849222",
"telephone_number": "951-301-5380",
"fax_number": "951-301-5390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOSO",
"first_name": "TERESA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-15",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "HI",
"license": "MD13280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.