Provider Demographics
NPI:1518909548
Name:WARWAR, ROBERT J (M D)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:WARWAR
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 N BRENT ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2808
Mailing Address - Country:US
Mailing Address - Phone:805-648-3063
Mailing Address - Fax:
Practice Address - Street 1:72 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2808
Practice Address - Country:US
Practice Address - Phone:805-648-3063
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA050352174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF35397Medicare UPIN
CAWA50342AMedicare ID - Type UnspecifiedMEDICARE PPIN NUMBER