Healthcare Provider Details

I. General information

NPI: 1841279668
Provider Name (Legal Business Name): ROBERT THOMAS HORVAT MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 HOSPITAL RD ENDOCRINE CLINIC
ATWATER CA
95301-5173
US

IV. Provider business mailing address

3605 HOSPITAL RD ENDOCRINE CLINIC
ATWATER CA
95301-5173
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-5500
  • Fax:
Mailing address:
  • Phone: 209-383-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA062483
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA062483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: