Healthcare Provider Details

I. General information

NPI: 1851506083
Provider Name (Legal Business Name): ROBERT KOBLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD #115
BEVERLY HILLS CA
90211-2142
US

IV. Provider business mailing address

150 N ROBERTSON BLVD #115
BEVERLY HILLS CA
90211-2142
US

V. Phone/Fax

Practice location:
  • Phone: 310-657-8500
  • Fax: 310-657-0579
Mailing address:
  • Phone: 310-657-8500
  • Fax: 310-657-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG7117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: