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General NPI Number Information
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NPI Number | 1053451757
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Entity Type | Organization
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Legal Business Name | ROBERT E MCCOY, MD, INC.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 1440 N HARBOR BLVD STE 100
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City | FULLERTON
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State | CA
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Zip | 92835-4127
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Country | US
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Telephone | 714-447-3144
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Fax | 714-447-1944
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Provider Business Mailing Address
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Address Line | 1440 N HARBOR BLVD STE 100
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City | FULLERTON
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State | CA
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Zip | 92835-4127
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Country | US
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Telephone | 714-447-3144
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Fax | 714-447-1944
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT EMMITT MCCOY
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Credential | MD
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Telephone | 714-447-3144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A43126
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License Number State | CA
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