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NPI Code Detail

MEDICARE: MR. ROBERT WEBSTER

MEDICARE: MR. ROBERT WEBSTER
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
1101YA0400XAddiction (Substance Use Disorder) CounselorC057240618CA

General Provider Information

NPI Number : 1811040181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT WEBSTER
Provider Business Mailing Address
First Line : 47395 MONROE ST APT 217
Second Line :
City : INDIO
State : CA
Zip : 92201-6700
Country : US
Telephone Number : 760-219-8563
Fax Number :
Provider Business Practice Location Address
First Line : 44199 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-3096
Country : US
Telephone Number : 760-393-3261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 09/12/2023

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