MEDICARE: MR. ROBERT SHELDON PALLAS 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	208D00000X	General Practice Physician	A32895	CA

General Provider Information

NPI Number	:	1447389085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT SHELDON PALLAS M.D.

Provider Business Mailing Address
First Line	:	1138 PALO VERDE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4664
Country	:	US
Telephone Number	:	310-313-3161
Fax Number	:	310-313-3172

Provider Business Practice Location Address
First Line	:	1138 PALO VERDE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4664
Country	:	US
Telephone Number	:	310-313-3161
Fax Number	:	310-313-3172

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	02/06/2013

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