Provider Demographics
NPI:1033500780
Name:ANTHIS, ROBERT CRISTIAN (HAD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CRISTIAN
Last Name:ANTHIS
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N PINAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-3336
Mailing Address - Country:US
Mailing Address - Phone:520-494-2242
Mailing Address - Fax:
Practice Address - Street 1:1201 N PINAL AVE STE A
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-3336
Practice Address - Country:US
Practice Address - Phone:520-494-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7730237700000X
AZ13580237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7730OtherCALIFORNIA SPEECH, LANGUAGE PATHOLOGY, AUDIOLOGY & HEARING AID DISPENSERS BOARD