Provider Demographics
NPI:1376678284
Name:CHARLES J WROBEL MD INC
Entity Type:Organization
Organization Name:CHARLES J WROBEL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:H
Authorized Official - Last Name:AFFENTRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-835-1148
Mailing Address - Street 1:9300 STOCKDALE HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3613
Mailing Address - Country:US
Mailing Address - Phone:661-665-0505
Mailing Address - Fax:
Practice Address - Street 1:9300 STOCKDALE HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3613
Practice Address - Country:US
Practice Address - Phone:661-665-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49725207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00141525OtherRAILROAD MEDICARE
CA00G497252Medicaid
CAZZZ28574ZMedicare ID - Type Unspecified
CAP00141525OtherRAILROAD MEDICARE