Reznik, Vivian Mary

Reznik, Vivian Mary is an individual health care provider with primary practice located at 8001 Frost St Entrance 10, San Diego CA 92123-2746. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is her primary health care specialty. Reznik, Vivian Mary can be contacted via phone (858) 966-8052.

Contact Information

Primary practice address
8001 Frost St Entrance 10 San Diego CA 92123-2746
Phone: (858) 966-8052
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G36058 California
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X G36058 California

Profile Details

NPI number 1770654535
LBN Legal business name Reznik, Vivian Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Sep 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770654535 NPPES
California MEDICAID 00G360580

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