Provider Demographics
NPI:1184757791
Name:WARNOCK, ROBERT SEAN (ARNP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SEAN
Last Name:WARNOCK
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2664
Mailing Address - Country:US
Mailing Address - Phone:213-741-8330
Mailing Address - Fax:213-741-8388
Practice Address - Street 1:403 W ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2664
Practice Address - Country:US
Practice Address - Phone:213-741-8330
Practice Address - Fax:213-741-8388
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9190363363L00000X
CA11779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305491800Medicaid
CA1942300918OtherNPI EMPLOYER
1184757791OtherNPI PERSONAL
FL305491800Medicaid
FLE8444WMedicare Oscar/Certification
FLE8444TMedicare PIN
FLE8444SMedicare PIN
CA1942300918OtherNPI EMPLOYER