Provider Demographics
NPI:1235289695
Name:MAYER, ROB ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROB
Middle Name:ARTHUR
Last Name:MAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-2602
Mailing Address - Country:US
Mailing Address - Phone:559-992-2009
Mailing Address - Fax:559-992-2009
Practice Address - Street 1:1140 CHASE AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-2602
Practice Address - Country:US
Practice Address - Phone:559-992-2009
Practice Address - Fax:559-992-2009
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0233170Medicare PIN
CAU54761Medicare UPIN