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NPI Code Detail

MEDICARE: DR. ROBERT A MECUM M.D.

MEDICARE:  DR. ROBERT A MECUM  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG78258CA
2207RG0100XGastroenterology PhysicianG78258CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114945680
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT A MECUM M.D.
Provider Business Mailing Address
First Line : 1605 EUSTON RD
Second Line :
City : SAN MARINO
State : CA
Zip : 91108-1917
Country : US
Telephone Number : 562-789-5577
Fax Number : 562-789-5567
Provider Business Practice Location Address
First Line : 12291 WASHINGTON BLVD STE 304
Second Line :
City : WHITTIER
State : CA
Zip : 90606-2551
Country : US
Telephone Number : 562-789-5577
Fax Number : 562-789-5567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 08/09/2016

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Directions to “ DR. ROBERT A MECUM M.D.” Practice Location

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