Gardner, Robert William

Gardner, Robert William is an sole proprietor health care provider with primary practice located at 6300 E. Hwy 20 , Lucerne CA 95458. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Gardner, Robert William can be contacted via phone (707) 274-9299.

Contact Information

Primary practice address
6300 E. Hwy 20 Lucerne CA 95458
Phone: (707) 274-9299
Fax: (707) 274-9297
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X G30366 California

Profile Details

NPI number 1023183829
LBN Legal business name Gardner, Robert William
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2006
Last updated Nov 1st, 2012 - about 12 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 1023183829 NPPES
California MEDICAID 00G303660

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