NPIMap

Organization Active NPI

Lyle J Reber MD Inc

  • Specialist
  • La Quinta, CA
National Provider Identifier
1881911287
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G68674 Issued in CA
Legal business name
LYLE J REBER MD INC
Practice address
47110 Washington St
Suite 104
La Quinta, CA 92253-2186
Phone
(760) 625-1650
Fax
(760) 625-1654
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Dr. Lyle J Reber, MD
Title
President
Phone
(760) 625-1650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G68674 CA Primary

Addresses

Primary practice location

47110 Washington St
Suite 104
La Quinta, CA 92253-2186

Mailing address

PO Box 6449
La Quinta, CA 92248-6449
Phone (760) 625-1650

Other identifiers 2

IdentifierTypeStateIssuer
1063444578OtherNPI
G68674OtherCASTATE

National Provider Directory

National Provider Directory
Tax ID family
Lyle J Reber MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

47110 Washington St
Ste 104
La Quinta, CA 92253
Phone (760) 625-1650

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1881911287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6449",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922486449",
            "telephone_number": "760-625-1650",
            "fax_number": "760-625-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47110 WASHINGTON ST",
            "address_2": "SUITE 104",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532186",
            "telephone_number": "760-625-1650",
            "fax_number": "760-625-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYLE J REBER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "REBER",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-625-1650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G68674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063444578",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "G68674",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.