Provider Demographics
NPI:1730259243
Name:MEHLER, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:MEHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:416 W LAS TUNAS DR
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1236
Mailing Address - Country:US
Mailing Address - Phone:626-281-7461
Mailing Address - Fax:626-281-8827
Practice Address - Street 1:416 W LAS TUNAS DR
Practice Address - Street 2:SUITE # 200
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1236
Practice Address - Country:US
Practice Address - Phone:626-281-7461
Practice Address - Fax:626-281-8827
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG12425207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G124250Medicaid
CAA38671Medicare UPIN
CA00G124250Medicaid