Healthcare Provider Details

I. General information

NPI: 1275465403
Provider Name (Legal Business Name): ROBERT LEE KAAREN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

42 BLUE HERON
IRVINE CA
92603-0307
US

IV. Provider business mailing address

42 BLUE HERON
IRVINE CA
92603-0307
US

V. Phone/Fax

Practice location:
  • Phone: 949-510-6106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG42624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: