=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760423768
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT S CADOTTE M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2006
-----------------------------------------------------
Last Update Date | 04/25/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 VALE ROAD GALEN INPATIENT PHYSICIANS
-----------------------------------------------------
City | SAN PABLO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-970-5689
-----------------------------------------------------
Fax | 510-970-5766
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 MORAGA RD
-----------------------------------------------------
City | MORAGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94556-1639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-284-1119
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A90464
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | MD164977
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------