MEDICARE: MRS. BARBARA HEINZ ROBERTUS P.A.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	1750318127	CA
2	363LF0000X	Family Nurse Practitioner	9648	CA
3	363AM0700X	Medical Physician Assistant	14652	CA

General Provider Information

NPI Number	:	1871503565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA HEINZ ROBERTUS P.A.

Provider Business Mailing Address
First Line	:	1300 E CYPRESS ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-4728
Country	:	US
Telephone Number	:	805-349-8972
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 E CYPRESS ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-4728
Country	:	US
Telephone Number	:	805-349-8972
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	01/18/2024

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