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NPI Code Detail

MEDICARE: DR. ROBERT MARIO TRAFELI D.O.

MEDICARE: DR. ROBERT MARIO TRAFELI D.O.
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
1207Q00000XFamily Medicine Physician20A5618CA
2207Q00000XFamily Medicine Physician5103325-1204UT

General Provider Information

NPI Number : 1235381781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT MARIO TRAFELI D.O.
Provider Business Mailing Address
First Line : 2128 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1718
Country : US
Telephone Number : 310-722-0033
Fax Number :
Provider Business Practice Location Address
First Line : 2128 PICO BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-1718
Country : US
Telephone Number : 310-722-0033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2008
Last Update Date : 10/15/2008

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