Healthcare Provider Details

I. General information

NPI: 1528039534
Provider Name (Legal Business Name): ROBERT LOUIS PAKTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 BROADWAY ST APT 1208
SAN FRANCISCO CA
94115-1565
US

IV. Provider business mailing address

2000 BROADWAY ST APT 1208
SAN FRANCISCO CA
94115-1565
US

V. Phone/Fax

Practice location:
  • Phone: 415-471-7960
  • Fax:
Mailing address:
  • Phone: 415-471-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number29859
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number29859
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: