Richard David Reynolds, PA-C
Individual provider Active NPI Physician Assistant · Huron, CA
NPI 1801934955 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801934955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA19020 (CA)
- Practice address
- 16928 11TH Street
Huron, CA 93234 - Phone
- (559) 945-2541
- Fax
- (559) 945-1107
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110720000224 | CA | Order and Referring Only - Physician Assistant | 3678768934 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Health Centers of the San Joaquin Valley | Past | Accepting new patients |
Interoperability endpoints
- richard.reynolds.1@17661.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19020 | CA | Yes |
Addresses
Primary practice location
16928 11TH Street
Huron, CA 93234
Mailing address
333 E Cinnamon Dr
Apt.#135
Lemoore, CA 93245-2885
Phone (559) 925-1591
Other providers in Huron, CA
- Alejandra Moreno Solorio
- Kayle Ortega
- Pierce & Rios Medical Corporation
- Ignacio Puente Nieto Sr.
- Reedley Community Hospital
- Henna Sahi
- Yessenia G Sanchez
- The Latino Equity Advocacy and Policy Institute
- Turning Point of Central California, Inc.
- United Health Centers of the San Joaquin Valley
All providers in Huron, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.