Provider Demographics
NPI:1790913051
Name:MERLE S ROBBOY M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MERLE S ROBBOY M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERLE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:ROBBOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-722-7170
Mailing Address - Street 1:355 PLACENTIA AVE.
Mailing Address - Street 2:SUITE 308
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 308
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC28448207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC284481OtherMEDICARE
DC284481OtherMEDICARE