Provider Demographics
NPI:1821053596
Name:GREENSTEIN, ROBERT (LAC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:EL VERANO
Mailing Address - State:CA
Mailing Address - Zip Code:95433-0086
Mailing Address - Country:US
Mailing Address - Phone:707-490-5972
Mailing Address - Fax:
Practice Address - Street 1:811 W NAPA ST
Practice Address - Street 2:SUITE R
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6426
Practice Address - Country:US
Practice Address - Phone:707-490-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3308171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist