Healthcare Provider Details

I. General information

NPI: 1972600427
Provider Name (Legal Business Name): ROBERT C KNIPPER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31469 RANCHO PUEBLO RD STE 100
TEMECULA CA
92592-4859
US

IV. Provider business mailing address

1135 CALISTOGA WAY
SAN MARCOS CA
92078-1018
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-6890
  • Fax:
Mailing address:
  • Phone: 760-842-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024166850
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: