Healthcare Provider Details

I. General information

NPI: 1235223009
Provider Name (Legal Business Name): ROBERT I DEUTSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CLINTON AVE
ALAMEDA CA
94501-4320
US

IV. Provider business mailing address

2070 CLINTON AVE
ALAMEDA CA
94501-4320
US

V. Phone/Fax

Practice location:
  • Phone: 510-814-4089
  • Fax: 510-521-4187
Mailing address:
  • Phone: 510-814-4089
  • Fax: 510-521-4187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG30023
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG30023
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG30023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: