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General NPI Number Information
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NPI Number | 1831227628
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Entity Type | Individual
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Provider Name | ROBERT J. IVORY
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2521 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2207
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Country | US
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Telephone | 916-734-4836
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 CORBIN WAY
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City | SACRAMENTO
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State | CA
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Zip | 95827-2340
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Country | US
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Telephone | 916-366-1080
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU1872
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License Number State | CA
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