Provider Demographics
NPI:1609911957
Name:MEYERS, ROBERT CHRISTOPHER (IDC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:MEYERS
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 PASEO CAMARILLO
Mailing Address - Street 2:APT 154
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-0895
Mailing Address - Country:US
Mailing Address - Phone:805-484-4465
Mailing Address - Fax:
Practice Address - Street 1:727 PASEO CAMARILLO
Practice Address - Street 2:APT 154
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-0895
Practice Address - Country:US
Practice Address - Phone:805-484-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider