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General NPI Number Information
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NPI Number | 1457488587
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Entity Type | Individual
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Provider Name | ROBERT PATRICK HOLLOWAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 566 S SAN VICENTE BLVD SUITE 201
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City | LOS ANGELES
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State | CA
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Zip | 90048-4650
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Country | US
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Telephone | 310-403-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 8581 SANTA MONICA BLVD PMB 432
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4120
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Country | US
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Telephone | 310-403-7878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | A55346
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License Number State | CA
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