Provider Demographics
NPI:1952117954
Name:ROBERT VIZZARD, MD, INC
Entity type:Organization
Organization Name:ROBERT VIZZARD, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VIZZARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-206-8953
Mailing Address - Street 1:6850 CHILI HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-9648
Mailing Address - Country:US
Mailing Address - Phone:916-206-8953
Mailing Address - Fax:
Practice Address - Street 1:6850 CHILI HILL RD
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:CA
Practice Address - Zip Code:95658-9648
Practice Address - Country:US
Practice Address - Phone:916-206-8953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty