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General NPI Number Information
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NPI Number | 1982197562
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Entity Type | Organization
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Legal Business Name | ROBERT D HESSELGESSER A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | 2200 LYNN RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-2071
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Country | US
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Telephone | 805-208-7006
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Fax | 208-437-2113
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Provider Business Mailing Address
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Address Line | 1731 SCHOOLHOUSE CIR
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-4257
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Country | US
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Telephone | 805-208-7006
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Fax | 208-437-2113
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Authorized Official
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Title or Position | CREDENTIALING DIRECTOR
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Name | DORENE GRIFFITH
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Credential |
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Telephone | 208-437-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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