Healthcare Provider Details

I. General information

NPI: 1265755417
Provider Name (Legal Business Name): ROBERT ANTHONY FERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LOWER RAGSDALE DR STE 100
MONTEREY CA
93940-5817
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-624-7070
  • Fax: 831-624-3612
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA108328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: