Provider Demographics
NPI:1275646507
Name:KOIDA, ROBERT K (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:KOIDA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:181 ANDRIEUX ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6932
Mailing Address - Country:US
Mailing Address - Phone:707-938-3870
Mailing Address - Fax:707-938-3895
Practice Address - Street 1:181 ANDRIEUX ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6932
Practice Address - Country:US
Practice Address - Phone:707-938-3870
Practice Address - Fax:707-938-3895
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG20444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine