Healthcare Provider Details

I. General information

NPI: 1891783338
Provider Name (Legal Business Name): ROBERT NORDMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13300 NEW AIRPORT RD STE 100
AUBURN CA
95602-7407
US

IV. Provider business mailing address

13300 NEW AIRPORT RD STE 100
AUBURN CA
95602-7407
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-8780
  • Fax: 530-889-8781
Mailing address:
  • Phone: 530-889-8780
  • Fax: 530-889-8781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number52402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: