Provider Demographics
NPI:1497865257
Name:AHEARN, ROBERT C (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:AHEARN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:18800 DELAWARE ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648
Mailing Address - Country:US
Mailing Address - Phone:714-841-5333
Mailing Address - Fax:714-841-5303
Practice Address - Street 1:18800 DELAWARE ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648
Practice Address - Country:US
Practice Address - Phone:714-841-5333
Practice Address - Fax:714-841-5303
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG54139A207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA911481OtherQME
G54139AMedicare UPIN
E57400Medicare UPIN