Provider Demographics
NPI:1871718783
Name:REISS, UZZI (MD)
Entity type:Individual
Prefix:
First Name:UZZI
Middle Name:
Last Name:REISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:UZIEL
Other - Middle Name:
Other - Last Name:REISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:414 N CAMDEN DR
Mailing Address - Street 2:750
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-247-1300
Mailing Address - Fax:310-205-0164
Practice Address - Street 1:414 N CAMDEN DR
Practice Address - Street 2:750
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-247-1300
Practice Address - Fax:310-205-0164
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35280207VG0400X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88327Medicare UPIN