Provider Demographics
NPI:1265017404
Name:ROBERT SIEW MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT SIEW MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-676-3511
Mailing Address - Street 1:2926 CANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2050
Mailing Address - Country:US
Mailing Address - Phone:626-676-3511
Mailing Address - Fax:626-486-0189
Practice Address - Street 1:10 CONGRESS ST STE 155
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3045
Practice Address - Country:US
Practice Address - Phone:626-521-5331
Practice Address - Fax:626-486-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty