Provider Demographics
NPI:1528391091
Name:ROBERTSON, SEAN
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:ROBERTSON
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 1:737 POST ST APT 1726
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-0506
Mailing Address - Country:US
Mailing Address - Phone:415-359-6343
Mailing Address - Fax:
Practice Address - Street 1:737 POST ST APT 1726
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-0506
Practice Address - Country:US
Practice Address - Phone:415-359-6343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program