Provider Demographics
NPI:1336150572
Name:SCRIBNER, ROBERT GEORGE (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:SCRIBNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SULLIVAN AVE
Mailing Address - Street 2:#308
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:650-755-1132
Mailing Address - Fax:650-755-1308
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:#308
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-755-1132
Practice Address - Fax:650-755-1308
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G244900208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0008390Medicaid
CAA42276Medicare UPIN
CAGR0008390Medicaid