Healthcare Provider Details

I. General information

NPI: 1225123979
Provider Name (Legal Business Name): ROBERT M BEARMAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16850 BEAR VALLEY RD
VICTORVILLE CA
92395-5794
US

IV. Provider business mailing address

PO BOX 7630
LAGUNA NIGUEL CA
92607-7630
US

V. Phone/Fax

Practice location:
  • Phone: 760-241-8000
  • Fax:
Mailing address:
  • Phone: 949-643-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M BEARMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-241-8000