Provider Demographics
NPI:1598823619
Name:SHORR, ROBERT J (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:SHORR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 571651
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91357-5716
Mailing Address - Country:US
Mailing Address - Phone:818-776-9555
Mailing Address - Fax:818-776-8883
Practice Address - Street 1:18455 BURBANK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-776-9555
Practice Address - Fax:818-776-8883
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG344392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A91599Medicare UPIN
CAG34439Medicare ID - Type Unspecified