Basic Information
| Provider Information | |||||||||
| NPI: | 1912131772 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | CHRYSTAL | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 127 SOUTH SAN VICENTE BLVD | ||||||||
| Address2: | SUITE A6600 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3101423647 | ||||||||
| FaxNumber: | 3104230148 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 SAN VICENTE BLVD, | ||||||||
| Address2: | DEPARTMENT OF NEUROLOGY | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102486842 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2009 | ||||||||
| LastUpdateDate: | 09/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | A123260 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 390200000X | 62878 | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.