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General NPI Number Information
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NPI Number | 1740375799
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Entity Type | Individual
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Provider Name | RONALD R. TRAVIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 S. BUENA VISTA STREET
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City | BURBANK
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State | CA
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Zip | 91505-4809
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Country | US
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Telephone | 818-845-8345
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Fax | 818-847-3935
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Provider Business Mailing Address
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Address Line | 101 S. FIRST STREET #1000
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City | BURBANK
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State | CA
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Zip | 91502-1928
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Country | US
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Telephone | 818-845-6206
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Fax | 818-845-9774
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A23583
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License Number State | CA
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