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General NPI Number Information
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NPI Number | 1447589353
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Entity Type | Organization
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Legal Business Name | JEROME A ROBSON M D INC
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 500 COFFEE ROAD SUITE E
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City | MODESTO
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State | CA
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Zip | 95355-4241
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Country | US
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Telephone | 209-521-1209
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Fax | 209-521-1215
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Provider Business Mailing Address
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Address Line | 817 COFFEE RD BUILDING C3
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City | MODESTO
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State | CA
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Zip | 95355-4241
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Country | US
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Telephone | 209-529-9603
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Fax | 209-529-6610
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEROME ANTHONY ROBSON
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Credential | MD
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Telephone | 209-529-9603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G32736
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G32736
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License Number State | CA
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