Provider Demographics
NPI:1639265770
Name:NEGER, ROBERT EDMOND (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDMOND
Last Name:NEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94011-1595
Mailing Address - Country:US
Mailing Address - Phone:408-971-1949
Mailing Address - Fax:408-971-1944
Practice Address - Street 1:2100 FOREST AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1422
Practice Address - Country:US
Practice Address - Phone:408-971-1949
Practice Address - Fax:408-971-1944
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26741207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26741Medicare UPIN