MEDICARE: ROBERT EMERSON GARDINER 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
1	2084P0800X	Psychiatry Physician	G66818	CA

General Provider Information

NPI Number	:	1447326319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT EMERSON GARDINER M.D.

Provider Business Mailing Address
First Line	:	504 N FARRELL DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-6215
Country	:	US
Telephone Number	:	914-588-9226
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 UNIVERSITY PKWY
Second Line	:	STUDENT HEALTH CENTER
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92407-2318
Country	:	US
Telephone Number	:	909-537-5241
Fax Number	:	909-537-7027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	03/10/2015

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