Healthcare Provider Details

I. General information

NPI: 1417901042
Provider Name (Legal Business Name): DAVID L ROBERTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26501 AVENUE 140
PORTERVILLE CA
93258-2000
US

IV. Provider business mailing address

1600 9TH ST ROOM 205 MAILSTOP 2-3
SACRAMENTO CA
95814-6414
US

V. Phone/Fax

Practice location:
  • Phone: 559-782-2222
  • Fax:
Mailing address:
  • Phone: 916-654-2431
  • Fax: 916-654-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG13290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: