Provider Demographics
NPI:1720187834
Name:ECKERT, ROBIN ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ANN
Last Name:ECKERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 CRESCENT BAY DR
Mailing Address - Street 2:STE D
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:949-725-0000
Mailing Address - Fax:949-494-9683
Practice Address - Street 1:105 CRESCENT BAY DR
Practice Address - Street 2:STE D
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651
Practice Address - Country:US
Practice Address - Phone:949-725-0000
Practice Address - Fax:949-494-9683
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine