MEDICARE: DR. ROBERT MICHAEL VICTOR DPM

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	213E00000X	Podiatrist	E4578	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00467744	OTHER	OR	RR MEDICARE PIN

General Provider Information

NPI Number	:	1528059300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MICHAEL VICTOR DPM

Provider Business Mailing Address
First Line	:	578 RIO LINDO AVE STE 4
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-1800
Country	:	US
Telephone Number	:	530-894-6195
Fax Number	:	530-894-6195

Provider Business Practice Location Address
First Line	:	578 RIO LINDO AVE STE 4
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-1800
Country	:	US
Telephone Number	:	530-894-6195
Fax Number	:	530-894-6195

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	02/24/2021

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Directions to “ DR. ROBERT MICHAEL VICTOR DPM” Practice Location

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