Healthcare Provider Details

I. General information

NPI: 1306903687
Provider Name (Legal Business Name): ROBERT F OLDT MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 W 5TH ST STE 180
OXNARD CA
93030-6563
US

IV. Provider business mailing address

1555 W 5TH ST STE 180
OXNARD CA
93030-6563
US

V. Phone/Fax

Practice location:
  • Phone: 805-985-5599
  • Fax: 805-985-2867
Mailing address:
  • Phone: 805-985-5599
  • Fax: 805-985-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT F OLDT
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 805-985-5599