Provider Demographics
NPI:1043256316
Name:EITCHES, ROBERT W
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:EITCHES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:925E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-657-4600
Mailing Address - Fax:310-657-6020
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:925E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-657-4600
Practice Address - Fax:310-657-6020
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44618207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92503Medicare UPIN
CAG44618Medicare ID - Type Unspecified