Provider Demographics
NPI:1407969231
Name:WESTON, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:WESTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:PHYSICIAN SUPPORT SERVICES, 2ND FLOOR
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-3620
Practice Address - Fax:916-536-3541
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2013-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67212207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3352636OtherCIGNA
CAMCMG126600OtherWESTERN HEALTH ADVANTAGE
CA000810342904OtherPHCS
CA1089835OtherGREAT WEST
CA4460351OtherAETNA
CA90037764OtherPACIFICARE
CA20066OtherINTERPLAN
CAG67212OtherBLUE CROSS
CA46396OtherFIRST HEALTH
CA725812OtherUNITED HEALTHCARE
CA034772OtherHEALTH NET
CA725812OtherUNITED HEALTHCARE
CA90037764OtherPACIFICARE