Healthcare Provider Details

I. General information

NPI: 1861070336
Provider Name (Legal Business Name): ROBERT EWING MCALISTER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BALDWIN PARK BLVD
BALDWIN PARK CA
91706-5806
US

IV. Provider business mailing address

1011 BALDWIN PARK BLVD
BALDWIN PARK CA
91706-5806
US

V. Phone/Fax

Practice location:
  • Phone: 626-851-5272
  • Fax:
Mailing address:
  • Phone: 626-851-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA197571
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberA197571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: