Provider Demographics
NPI:1326186669
Name:SANET, ROBERT BENJAMIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BENJAMIN
Last Name:SANET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7898 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-1801
Mailing Address - Country:US
Mailing Address - Phone:619-464-7713
Mailing Address - Fax:619-464-7668
Practice Address - Street 1:7898 BROADWAY
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1801
Practice Address - Country:US
Practice Address - Phone:619-464-7713
Practice Address - Fax:619-464-7668
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5763152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70061Medicare UPIN