Roberts, Gregg John
Roberts, Gregg John is an sole proprietor health care provider with primary practice located at 24953 Paseo De Valencia Bldg A Ste 24A, Laguna Hills CA 92653-4342. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Roberts, Gregg John can be contacted via phone (949) 716-5280.Contact Information
Primary practice address
24953 Paseo De Valencia Bldg A Ste 24A
Laguna Hills CA 92653-4342
Phone: (949) 716-5280
Fax: (949) 716-5290
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6537T | California |
Profile Details
| NPI number | 1215934617 |
|---|---|
| LBN Legal business name | Roberts, Gregg John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215934617 | NPPES |
| California | Other | 5085460001 | DMERC |
| California | MEDICAID | SD0065370 | DMERC |
| California | Other | 06537 | DMERC |
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