Healthcare Provider Details

I. General information

NPI: 1376619528
Provider Name (Legal Business Name): ROBERT F SUBERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W FIR AVE SUITE 101
CLOVIS CA
93611-0223
US

IV. Provider business mailing address

221 W FIR AVE SUITE 101
CLOVIS CA
93611-0223
US

V. Phone/Fax

Practice location:
  • Phone: 559-299-7294
  • Fax: 559-239-0641
Mailing address:
  • Phone: 559-299-7294
  • Fax: 559-239-0641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG21306
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: