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NPI Code Detail

MEDICARE: DR. ROBERT ALAN KUTNER PSYD

MEDICARE:  DR. ROBERT ALAN KUTNER  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical NeuropsychologistPY0591NV
2103T00000XPsychologistPY0591NV
3103T00000XPsychologistPY4623FL
4103TB0200XCognitive & Behavioral PsychologistPY4623FL
5103TF0200XForensic PsychologistPY4623FL
6103TC0700XClinical PsychologistPY4623FL

General Provider Information

NPI Number : 1093763161
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT ALAN KUTNER PSYD
Provider Business Mailing Address
First Line : 3890 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4416
Country : US
Telephone Number : 213-222-8197
Fax Number : 702-974-0821
Provider Business Practice Location Address
First Line : 3890 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4416
Country : US
Telephone Number : 213-222-8197
Fax Number : 702-974-0821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 06/11/2019

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