Ettenger, Robert Bruce

Ettenger, Robert Bruce is an individual health care provider with primary practice located at 10833 Le Conte Ave 12-441 Mdcc, Los Angeles CA 90095-3075. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as his primary health care specialty. Ettenger, Robert Bruce can be contacted via phone (310) 206-3952.

Contact Information

Primary practice address
10833 Le Conte Ave 12-441 Mdcc Los Angeles CA 90095-3075
Phone: (310) 206-3952
Fax: (310) 206-0209
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X C36820 California

Profile Details

NPI number 1043233661
LBN Legal business name Ettenger, Robert Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043233661 NPPES
California MEDICAID GR0053510
California MEDICAID 00C368200

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