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General NPI Number Information
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NPI Number | 1689232829
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Entity Type | Individual
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Provider Name | ROBERT DALE HALL II PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 4000 BIRCH ST STE 120
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2258
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Country | US
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Telephone | 949-642-8057
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Fax | 949-642-0725
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Provider Business Mailing Address
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Address Line | 2813 MOOSE CREEK TRL
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City | SUAMICO
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State | WI
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Zip | 54313-3260
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Country | US
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Telephone | 949-422-6782
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29479
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License Number State | CA
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