Healthcare Provider Details

I. General information

NPI: 1679484398
Provider Name (Legal Business Name): ROBERT C MESSER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20001 HIGHWAY 108
SONORA CA
95370-8422
US

IV. Provider business mailing address

19401 SUSAN WAY
SONORA CA
95370-9266
US

V. Phone/Fax

Practice location:
  • Phone: 209-588-6164
  • Fax:
Mailing address:
  • Phone: 209-588-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: