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General NPI Number Information
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NPI Number | 1932154788
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Entity Type | Organization
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Legal Business Name | J ROBERT WEST, M.D., INC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 400 NEWPORT CENTER DR STE 702
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7669
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Country | US
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Telephone | 949-644-0101
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Fax | 949-644-1868
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Provider Business Mailing Address
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Address Line | 12700 PARK CENTRAL DR STE 1210
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City | DALLAS
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State | TX
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Zip | 75251-1522
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Country | US
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Telephone | 214-618-6123
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Fax | 949-783-2880
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | LUCIUS BLANCHARD
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Credential | M.D.
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Telephone | 214-618-6123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | G4302
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | C53342
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | G4302
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | C53342
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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