Provider Demographics
NPI:1598308660
Name:ISCHINGER, ROBERT HAROLD
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HAROLD
Last Name:ISCHINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 N INDIAN CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3019
Mailing Address - Country:US
Mailing Address - Phone:760-320-3456
Mailing Address - Fax:
Practice Address - Street 1:1910 S CAMINO REAL
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-9290
Practice Address - Country:US
Practice Address - Phone:760-320-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
53998101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1349889OtherLOCKTON COMPANIES