Provider Demographics
NPI:1407924137
Name:ROBERT F. NEMEROFF, M.D., INC.
Entity Type:Organization
Organization Name:ROBERT F. NEMEROFF, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:NEMEROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-441-0051
Mailing Address - Street 1:9663 SANTA MONICA BLVD
Mailing Address - Street 2:#556
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4303
Mailing Address - Country:US
Mailing Address - Phone:310-441-0051
Mailing Address - Fax:310-441-0052
Practice Address - Street 1:1509 MANNING AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5813
Practice Address - Country:US
Practice Address - Phone:310-441-0051
Practice Address - Fax:310-441-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66348207YS0123X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Single Specialty