Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ericson P Reyes

Individual provider Nurse Practitioner · NPI 1740397413

Ericson P Reyes is a Nurse Practitioner in Lakewood, California. Qualified in 2005, 21 years ago. Practices with Southland Renal Medical Group Inc, an 8-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2006

Practice location Address checks out

3300 E South St Ste 308
Lakewood, CA 90805-4598
Phone: (562) 630-3111
Fax: (562) 630-3107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence NP15834 (CA)

Record details

NPI number1740397413
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 25, 2006
Last updated in NPPESOctober 10, 2023
Certification dateOctober 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Southland Renal Medical Group Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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