MEDICARE: DR. ROBERT B HEPPS M.D.

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
1	2084P0800X	Psychiatry Physician	G166920	CA

General Provider Information

NPI Number	:	1457441545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT B HEPPS M.D.

Provider Business Mailing Address
First Line	:	3471 CRANE WAY
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-2638
Country	:	US
Telephone Number	:	510-530-8357
Fax Number	:	510-530-3421

Provider Business Practice Location Address
First Line	:	1515 YGNACIO VALLEY RD
Second Line	:	SUITE F
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-3063
Country	:	US
Telephone Number	:	925-938-9673
Fax Number	:	925-938-9559

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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