Provider Demographics
NPI:1104864396
Name:MUELLER, ROBERT ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:MUELLER
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 1:1900 POWELL ST, SUITE 300
Mailing Address - Street 2:SUTTER CARE AT HOME
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1815
Mailing Address - Country:US
Mailing Address - Phone:510-450-8730
Mailing Address - Fax:206-744-9976
Practice Address - Street 1:700 CLAREMONT ST, SUITE 220
Practice Address - Street 2:SUTTER VNA & HOSPICE
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1452
Practice Address - Country:US
Practice Address - Phone:206-744-9102
Practice Address - Fax:206-744-9976
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52372207P00000X
WAMD-60135840207PH0002X
CAG52370207PH0002X
WAMD60135840207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G523720Medicaid
WAMD60135840OtherWA STATE MEDICAL LICENSE NO. DEPT OF HEALTH
A52241Medicare UPIN
CAA52241Medicare UPIN
CA00G523720Medicaid