Provider Demographics
NPI:1073557294
Name:UYEDA, ROBERT Y (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:Y
Last Name:UYEDA
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 1:1950 SAWTELLE BLVD
Mailing Address - Street 2:#145
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7014
Mailing Address - Country:US
Mailing Address - Phone:310-271-2178
Mailing Address - Fax:310-575-4250
Practice Address - Street 1:465 NORTH ROXBURY DRIVE
Practice Address - Street 2:#1012
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4213
Practice Address - Country:US
Practice Address - Phone:310-271-2178
Practice Address - Fax:310-271-2169
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34366208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91583Medicare UPIN