Provider Demographics
NPI:1326127432
Name:SYLVESTER, ROBERT PATRICK (CPED)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:SYLVESTER
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1403
Mailing Address - Country:US
Mailing Address - Phone:707-445-8690
Mailing Address - Fax:707-445-8690
Practice Address - Street 1:1670 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1403
Practice Address - Country:US
Practice Address - Phone:707-445-8690
Practice Address - Fax:707-445-8690
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6010360001Medicare NSC