Provider Demographics
NPI:1437172509
Name:SUTTER, ROBERT C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:SUTTER
Suffix:JR
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:23961 CALLE DE LA MAGDALENA
Mailing Address - Street 2:#317
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3616
Mailing Address - Country:US
Mailing Address - Phone:949-837-1133
Mailing Address - Fax:949-830-1154
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:#317
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-837-1133
Practice Address - Fax:949-830-1154
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG222672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89355Medicare UPIN