Provider Demographics
NPI:1558439653
Name:HINES, ROBERT H JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:HINES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 HARBOR DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94965-1454
Mailing Address - Country:US
Mailing Address - Phone:415-380-0480
Mailing Address - Fax:415-380-8788
Practice Address - Street 1:3 HARBOR DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-1454
Practice Address - Country:US
Practice Address - Phone:415-380-0480
Practice Address - Fax:415-380-8788
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2011-10-21
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Provider Licenses
StateLicense IDTaxonomies
CAC392262084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37089Medicare UPIN
CA00C392260Medicare ID - Type Unspecified