Provider Demographics
NPI:1407560477
Name:LABORETE, ROBERT MAS
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MAS
Last Name:LABORETE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5285 TOSCANA WAY APT 819
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5325
Mailing Address - Country:US
Mailing Address - Phone:858-610-4096
Mailing Address - Fax:
Practice Address - Street 1:5285 TOSCANA WAY APT 819
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5325
Practice Address - Country:US
Practice Address - Phone:619-808-3765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance