Southmayd, Robert Charles

Southmayd, Robert Charles is an individual health care provider with primary practice located at 420 W Acacia St Suite 11, Stockton CA 95203-2441. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Southmayd, Robert Charles can be contacted via phone (209) 948-4098.

Contact Information

Primary practice address
420 W Acacia St Suite 11 Stockton CA 95203-2441
Phone: (209) 948-4098
Fax: (209) 948-2334
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 20A5298 California

Profile Details

NPI number 1982700969
LBN Legal business name Southmayd, Robert Charles
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Aug 26th, 2015 - about 9 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 1982700969 NPPES
California Other 911803606 BLUE SHIELD
California MEDICAID 00AX52980 BLUE SHIELD
California Other 160038160 BLUE SHIELD

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