Healthcare Provider Details

I. General information

NPI: 1578520664
Provider Name (Legal Business Name): ROBERT H STANLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 COHASSET RD
CHICO CA
95926-2242
US

IV. Provider business mailing address

277 COHASSET RD
CHICO CA
95926-2242
US

V. Phone/Fax

Practice location:
  • Phone: 530-781-1440
  • Fax: 530-342-1663
Mailing address:
  • Phone: 530-781-1440
  • Fax: 530-342-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC36872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: