MEDICARE: MERLE S ROBBOY M.D., A PROFESSIONAL CORPORATION

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	207V00000X	Obstetrics & Gynecology Physician	C28448	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC284481	OTHER		MEDICARE

General Provider Information

NPI Number	:	1790913051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERLE S ROBBOY M.D., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	355 PLACENTIA AVE.
Second Line	:	SUITE 308
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3303
Country	:	US
Telephone Number	:	949-722-7170
Fax Number	:	949-722-7990

Provider Business Practice Location Address
First Line	:	355 PLACENTIA AVE.
Second Line	:	SUITE 308
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3303
Country	:	US
Telephone Number	:	949-722-7170
Fax Number	:	949-722-7990

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MERLE STANLEY ROBBOY
Credential	:	M.D.
Telephone Number	:	949-722-7170

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	06/25/2009

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