Healthcare Provider Details

I. General information

NPI: 1093409856
Provider Name (Legal Business Name): ROBERT PARKER SIRRINE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # FE10
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # FE10
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5941
  • Fax:
Mailing address:
  • Phone: 559-353-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number65370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: