Provider Demographics
NPI:1134249980
Name:CANOVA, ROBERT WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:CANOVA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31941 DOVE CANYON DR.
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679
Mailing Address - Country:US
Mailing Address - Phone:949-293-1984
Mailing Address - Fax:949-293-1984
Practice Address - Street 1:31941 DOVE CANYON DR
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3718
Practice Address - Country:US
Practice Address - Phone:949-293-1984
Practice Address - Fax:949-293-1984
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor