Basic Information
Provider Information
NPI: 1922442920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTEL-CAZARES
FirstName: REYNALDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARTEL
OtherFirstName: REYNALDA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 2
Mailing Information
Address1: 10800 MAGNOLIA AVE
Address2: EMERGENCY DEPARMENT
City: RIVERSIDE
State: CA
PostalCode: 925053043
CountryCode: US
TelephoneNumber: 9513532000
FaxNumber:  
Practice Location
Address1: 10800 MAGNOLIA AVE
Address2: EMERGENCY DEPARMENT
City: RIVERSIDE
State: CA
PostalCode: 925053043
CountryCode: US
TelephoneNumber: 9513532000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/20/2013
LastUpdateDate: 12/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207P00000XA142536CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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