Provider Demographics
NPI:1861526865
Name:LITTLE, ROBERT MURRAY IV (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MURRAY
Last Name:LITTLE
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10106 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3510
Mailing Address - Country:US
Mailing Address - Phone:510-526-7300
Mailing Address - Fax:510-526-7300
Practice Address - Street 1:10106 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3510
Practice Address - Country:US
Practice Address - Phone:510-526-7300
Practice Address - Fax:510-526-7300
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0296700Medicare ID - Type Unspecified
CAV06955Medicare UPIN