ROBERT WILLIAM GARDNER NPI 1023183829

NPI Information

NPI: 1023183829
Provider Name: ROBERT WILLIAM GARDNER
Classification: Family Medicine - 207QA0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
6300 E. HWY 20
LUCERNE, CA
ZIP 95458
Phone: (707) 274-9299
Get Directions

Robert William Gardner is an addiction medicine family medicine in Lucerne, CA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Robert William Gardner NPI is 1023183829. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6300 E. HWY 20
LUCERNE, CA
ZIP 95458
Phone: (707) 274-9299
Fax: (707) 274-9297

The NPI 1023183829 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 11/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	G30366	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	A44393	MEDICARE UPIN	CALIFORNIA
2	00G303660	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
3	00G303660	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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