Provider Demographics
NPI:1114933371
Name:BELTRAN, ROBERT R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:BELTRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23046 AVENIDA DE LA CARLOTA
Mailing Address - Street 2:SUITE 632
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1548
Mailing Address - Country:US
Mailing Address - Phone:949-552-6444
Mailing Address - Fax:949-315-3329
Practice Address - Street 1:3500 BARRANCA PKWY
Practice Address - Street 2:STE. 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8226
Practice Address - Country:US
Practice Address - Phone:949-552-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG420932086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG42093BMedicare ID - Type Unspecified