Provider Demographics
NPI:1073544474
Name:PLOTKE, ROBERT JAY (RPT, DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAY
Last Name:PLOTKE
Suffix:
Gender:M
Credentials:RPT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 WHITEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3948
Mailing Address - Country:US
Mailing Address - Phone:805-416-6243
Mailing Address - Fax:818-887-7494
Practice Address - Street 1:23233 SATICOY ST STE 106
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-5360
Practice Address - Country:US
Practice Address - Phone:818-887-9111
Practice Address - Fax:818-887-7494
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 14472111N00000X
CAPT 8326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist