Provider Demographics
NPI:1639122799
Name:ROBBOY, MERLE STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:STANLEY
Last Name:ROBBOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MERLES
Other - Middle Name:
Other - Last Name:ROBBOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:355 PLACENTIA AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3303
Mailing Address - Country:US
Mailing Address - Phone:949-722-7170
Mailing Address - Fax:949-722-7990
Practice Address - Street 1:355 PLACENTIA AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3303
Practice Address - Country:US
Practice Address - Phone:949-722-7170
Practice Address - Fax:949-722-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC28448207V00000X
OH35028296207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OC284481Medicare ID - Type Unspecified
A33636Medicare UPIN