Healthcare Provider Details

I. General information

NPI: 1891861399
Provider Name (Legal Business Name): ROBERT H. LANGSTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST. SUITE #815
SAN FRANCISCO CA
94118
US

IV. Provider business mailing address

3838 CALIFORNIA ST. SUITE #815
SAN FRANCISCO CA
94118
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-6476
  • Fax: 415-221-3903
Mailing address:
  • Phone: 415-221-6476
  • Fax: 415-221-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG38057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: