Provider Demographics
NPI:1578657730
Name:CALIFORNIA EAR INSTITUTE, INC.
Entity Type:Organization
Organization Name:CALIFORNIA EAR INSTITUTE, INC.
Other - Org Name:CALIFORNIA EAR INSTITUTE AT SANTA ROSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBERSON, JR
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:650-462-3149
Mailing Address - Street 1:1900 UNIVERSITY AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:E PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2212
Mailing Address - Country:US
Mailing Address - Phone:650-462-3137
Mailing Address - Fax:650-322-8228
Practice Address - Street 1:196 SOTOYOME ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4800
Practice Address - Country:US
Practice Address - Phone:707-528-0565
Practice Address - Fax:707-528-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A212320174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty