Healthcare Provider Details

I. General information

NPI: 1326195082
Provider Name (Legal Business Name): ROBERT RAY REDFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

V. Phone/Fax

Practice location:
  • Phone: 714-880-7812
  • Fax:
Mailing address:
  • Phone: 215-615-4949
  • Fax: 215-662-2244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD436835
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberC184403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: