Provider Demographics
NPI:1730571555
Name:REID, CHERYL LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LYNNE
Last Name:REID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 S MADISON AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3300
Mailing Address - Country:US
Mailing Address - Phone:626-577-5602
Mailing Address - Fax:
Practice Address - Street 1:482 S MADISON AVE
Practice Address - Street 2:UNIT 3
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3300
Practice Address - Country:US
Practice Address - Phone:626-577-5602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39921207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease