MEDICARE: DR. ROBERT LOWELL DUNCANSON 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	208000000X	Pediatrics Physician	A21712	CA

General Provider Information

NPI Number	:	1619026929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LOWELL DUNCANSON M.D.

Provider Business Mailing Address
First Line	:	1773 VISTA VIEW TER
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-5676
Country	:	US
Telephone Number	:	951-780-2440
Fax Number	:	951-780-6420

Provider Business Practice Location Address
First Line	:	1773 VISTA VIEW TER
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-5676
Country	:	US
Telephone Number	:	951-780-2440
Fax Number	:	951-780-6420

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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