Provider Demographics
NPI:1497184261
Name:ROBERT E. NEGER, M.D.
Entity type:Organization
Organization Name:ROBERT E. NEGER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDMOND
Authorized Official - Last Name:NEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-971-1949
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94011-1595
Mailing Address - Country:US
Mailing Address - Phone:408-971-1949
Mailing Address - Fax:408-971-1944
Practice Address - Street 1:2100 FOREST AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1422
Practice Address - Country:US
Practice Address - Phone:408-971-1949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A26741152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A267410Medicaid
CA00A267410Medicaid