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General NPI Number Information
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NPI Number | 1477882413
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Entity Type | Organization
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Legal Business Name | ROBERT W BEART, JR., M.D., INC
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 222 W EULALIA ST SUITE 100A
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City | GLENDALE
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State | CA
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Zip | 91204-2849
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Country | US
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Telephone | 818-244-8161
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Fax | 818-244-5122
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Provider Business Mailing Address
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Address Line | 222 W EULALIA ST SUITE 100A
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City | GLENDALE
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State | CA
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Zip | 91204-2849
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Country | US
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Telephone | 818-244-8161
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Fax | 818-244-5122
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT W BEART JR.
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Credential | M.D.
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Telephone | 818-244-8161
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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 | G76196
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License Number State | CA
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