Provider Demographics
NPI:1851423412
Name:MITTENDORFF, ROBERT EDWARD II (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD
Last Name:MITTENDORFF
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:555 BRYANT ST
Mailing Address - Street 2:SUITE 344
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1704
Mailing Address - Country:US
Mailing Address - Phone:650-704-1639
Mailing Address - Fax:617-249-1586
Practice Address - Street 1:1425 S MAIN ST
Practice Address - Street 2:EMERGENCY DEPARTMENT OFFICE
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5318
Practice Address - Country:US
Practice Address - Phone:650-704-1639
Practice Address - Fax:617-249-1586
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2012-10-17
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Provider Licenses
StateLicense IDTaxonomies
CA97066207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine