Provider Demographics
NPI:1578520664
Name:STANLEY, ROBERT H (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:STANLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 COHASSET RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2242
Mailing Address - Country:US
Mailing Address - Phone:530-781-1440
Mailing Address - Fax:530-342-1663
Practice Address - Street 1:277 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2242
Practice Address - Country:US
Practice Address - Phone:530-781-1440
Practice Address - Fax:530-342-1663
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36872208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C368720Medicaid
CA00C368720Medicaid
CA00C368720Medicare PIN