Individual ProviderWarren L. ReidelInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address10666 N Torrey Pines Rd, La Jolla, CA 92037-1027(858) 554-8054PECOS EnrollmentBased on the most recent information from CMS, provider Warren L. Reidel does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1942272976Provider TypeIndividualFull NameReidel, Warren L.TitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date2/3/2006Last Updated9/24/2019Contact InformationPractice LocationPractice Address10666 N Torrey Pines Rd, La Jolla, CA 92037-1027Phone(858) 554-8054FaxUnlisted FaxMailing LocationMailing Address10790 Rancho Bernardo Rd, San Diego, CA 92127-5705Phone(858) 554-8054FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RG0100XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseG37420CaliforniaProvider IdentifiersIDDescriptionIssuerID00G374200DescriptionMedicaidIssuerUnlistedCalifornia