Provider Demographics
NPI:1811075302
Name:HEISTER, ROBYN REBECCA (MD)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:REBECCA
Last Name:HEISTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:HEISTER
Other - Last Name:GIRARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2185 CITRACADO PARKWAY
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029
Mailing Address - Country:US
Mailing Address - Phone:442-281-5000
Mailing Address - Fax:
Practice Address - Street 1:2185 W CITRACADO PKWY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4159
Practice Address - Country:US
Practice Address - Phone:442-281-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80686207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A806860Medicaid
I39346Medicare UPIN
00A806860Medicare ID - Type Unspecified