Healthcare Provider Details

I. General information

NPI: 1205937620
Provider Name (Legal Business Name): ROBERT L ORTH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 N CHERRY ST
TULARE CA
93274-2251
US

IV. Provider business mailing address

1062 N CHERRY ST
TULARE CA
93274-2251
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-3824
  • Fax: 559-686-3741
Mailing address:
  • Phone: 559-686-3824
  • Fax: 559-686-3741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA87274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: