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General NPI Number Information
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NPI Number | 1306036124
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Entity Type | Organization
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Legal Business Name | ROBERT SKVERSKY, M.D., INC.
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 320 SUPERIOR AVE SUITE 210
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2716
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Country | US
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Telephone | 949-645-2930
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Fax | 949-645-1059
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Provider Business Mailing Address
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Address Line | 320 SUPERIOR AVE SUITE 210
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2716
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Country | US
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Telephone | 949-645-2930
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Fax | 949-645-1059
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Authorized Official
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Title or Position | PRINCIPAL
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Name | ROBERT NMI SKVERSKY
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Credential | M.D.
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Telephone | 949-645-2930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G21450
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License Number State | CA
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