Healthcare Provider Details

I. General information

NPI: 1598813230
Provider Name (Legal Business Name): ROBERT WESLEY HUTCHERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9675 BRIGHTON WAY SUITE 410
BEVERLY HILLS CA
90210-5100
US

IV. Provider business mailing address

9675 BRIGHTON WAY SUITE 410
BEVERLY HILLS CA
90210-5100
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-7012
  • Fax: 310-274-5530
Mailing address:
  • Phone: 310-276-7012
  • Fax: 310-274-5530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberG34011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: