Provider Demographics
NPI:1538230347
Name:PATTERSON, ROBERT A (MPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1201
Mailing Address - Country:US
Mailing Address - Phone:805-230-2673
Mailing Address - Fax:805-230-2134
Practice Address - Street 1:325 ROLLING OAKS DR
Practice Address - Street 2:SUITE 250
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1201
Practice Address - Country:US
Practice Address - Phone:805-230-2673
Practice Address - Fax:805-230-2134
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19840225100000X, 2251E1200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17180Medicare ID - Type UnspecifiedGROUP ID
CAS81676Medicare UPIN
CAWPT19840DMedicare ID - Type UnspecifiedPPIN