Healthcare Provider Details

I. General information

NPI: 1457988065
Provider Name (Legal Business Name): ROBERT CHOOLJIAN GUNZENHAUSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1298 W 7TH ST
UPLAND CA
91786-7035
US

IV. Provider business mailing address

PO BOX 1075
DANA POINT CA
92629-5075
US

V. Phone/Fax

Practice location:
  • Phone: 909-315-6891
  • Fax: 909-946-3937
Mailing address:
  • Phone: 909-315-6891
  • Fax: 909-946-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberA189179
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA189179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: