Provider Demographics
NPI:1538292685
Name:SEARS PEDIATRICS AND FAMILY MEDICINE
Entity Type:Organization
Organization Name:SEARS PEDIATRICS AND FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-493-5437
Mailing Address - Street 1:26933 CAMINO DE ESTRELLA
Mailing Address - Street 2:SUITE #A
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1602
Mailing Address - Country:US
Mailing Address - Phone:949-493-5437
Mailing Address - Fax:949-493-0535
Practice Address - Street 1:26933 CAMINO DE ESTRELLA
Practice Address - Street 2:SUITE #A
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1602
Practice Address - Country:US
Practice Address - Phone:949-493-5437
Practice Address - Fax:949-493-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA60936OtherMEDICAL LICENSE