Provider Demographics
NPI:1578539516
Name:SIEW, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SIEW
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 1:10 CONGRESS ST STE 155
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3027
Mailing Address - Country:US
Mailing Address - Phone:626-384-5092
Mailing Address - Fax:626-486-0189
Practice Address - Street 1:10 CONGRESS ST STE 155
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3027
Practice Address - Country:US
Practice Address - Phone:626-521-5331
Practice Address - Fax:626-486-0181
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A453330Medicaid
CAW481Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CAF57067Medicare UPIN