Provider Demographics
NPI:1114209533
Name:CRAIG, ROBERT CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:CRAIG
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 1:26014 MIRAGE CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-1773
Mailing Address - Country:US
Mailing Address - Phone:951-488-1734
Mailing Address - Fax:
Practice Address - Street 1:26014 MIRAGE CT
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-1773
Practice Address - Country:US
Practice Address - Phone:951-488-1734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies