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NPI Code Detail

MEDICARE: ROBERT E. DEVELLE PA-C

MEDICARE: ROBERT E. DEVELLE PA-C
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
1363A00000XPhysician AssistantPA1507NV
2363A00000XPhysician AssistantPA13924CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PA13924OTHERCAMEDICAL LICENSE

General Provider Information

NPI Number : 1598709248
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT E. DEVELLE PA-C
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number : 702-838-1456
Provider Business Practice Location Address
First Line : 333 1ST ST STE A
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94105-2661
Country : US
Telephone Number : 888-803-3370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/23/2025

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Directions to “ ROBERT E. DEVELLE PA-C” Practice Location

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