Provider Demographics
NPI:1649482027
Name:DUBRO, ROBERT E (DC, DACBOH, DABCO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:DUBRO
Suffix:
Gender:M
Credentials:DC, DACBOH, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46923 WARM SPRINGS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7914
Mailing Address - Country:US
Mailing Address - Phone:510-657-9367
Mailing Address - Fax:510-657-3607
Practice Address - Street 1:46923 WARM SPRINGS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7914
Practice Address - Country:US
Practice Address - Phone:510-657-9367
Practice Address - Fax:510-657-3607
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18783111NX0100X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NX0100XChiropractic ProvidersChiropractorOccupational Health
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0187830Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAU33650Medicare UPIN