Basic Information
Provider Information
NPI: 1528326477
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VON REINHART
FirstName: ANNA
MiddleName: ELISABETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2625 E DIVISADERO ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937211431
CountryCode: US
TelephoneNumber: 5594432682
FaxNumber: 5594432681
Practice Location
Address1: 2823 FRESNO ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937211324
CountryCode: US
TelephoneNumber: 5594996440
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2012
LastUpdateDate: 12/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X313949NYY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XA143611CAN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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