Provider Demographics
NPI: | 1003085192 |
---|---|
Name: | PRICE, ROBERT H (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | ROBERT |
Middle Name: | H |
Last Name: | PRICE |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 140 CASA ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN LUIS OBISPO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93405-1804 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 805-242-4181 |
Mailing Address - Fax: | 805-242-4180 |
Practice Address - Street 1: | 140 CASA ST |
Practice Address - Street 2: | |
Practice Address - City: | SAN LUIS OBISPO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93405-1804 |
Practice Address - Country: | US |
Practice Address - Phone: | 805-242-4181 |
Practice Address - Fax: | 805-242-4180 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-02-22 |
Last Update Date: | 2023-03-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A43730 | 204R00000X, 2084S0012X, 2084N0400X |
WA | MD00025709 | 2084N0400X |
ID | M9024 | 2084N0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No | 204R00000X | Allopathic & Osteopathic Physicians | Electrodiagnostic Medicine | |
No | 2084S0012X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |