Provider Demographics
NPI:1144802711
Name:TOTTEN, ROBERT JUSTIS
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JUSTIS
Last Name:TOTTEN
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 1:6501 W CHARLESTON BLVD # C215
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1006
Mailing Address - Country:US
Mailing Address - Phone:702-525-5365
Mailing Address - Fax:
Practice Address - Street 1:100 S 14TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-5314
Practice Address - Country:US
Practice Address - Phone:702-333-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator