Healthcare Provider Details

I. General information

NPI: 1982763116
Provider Name (Legal Business Name): ROBERT F METH MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK EAST STE 810
LOS ANGELES CA
90067
US

IV. Provider business mailing address

2080 CENTURY PARK E STE 810
LOS ANGELES CA
90067-2001
US

V. Phone/Fax

Practice location:
  • Phone: 310-556-1377
  • Fax: 310-556-1650
Mailing address:
  • Phone: 310-556-1377
  • Fax: 310-556-1650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberA23773
License Number State

VIII. Authorized Official

Name: ROBERT F METH
Title or Position: OWNER
Credential: MD
Phone: 310-556-1377