Provider Demographics
NPI:1689608176
Name:YOERG, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:YOERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 MELANIE LANE
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027
Mailing Address - Country:US
Mailing Address - Phone:650-369-2110
Mailing Address - Fax:650-369-6681
Practice Address - Street 1:1301E RALSTON AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002
Practice Address - Country:US
Practice Address - Phone:650-592-8750
Practice Address - Fax:656-059-4929
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG157262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10978819OtherCAQH
CA00G157260Medicare ID - Type Unspecified