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NPI Code Detail

MEDICARE: ROBERT DONALD BRONNER

MEDICARE:   ROBERT DONALD BRONNER
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1235412628
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DONALD BRONNER
Provider Business Mailing Address
First Line : 9411 VELARDO DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-2316
Country : US
Telephone Number : 949-864-9712
Fax Number :
Provider Business Practice Location Address
First Line : 9411 VELARDO DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-2316
Country : US
Telephone Number : 949-864-9712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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