Devereaux, Robert Allan

Devereaux, Robert Allan is an individual health care provider with primary practice located at 11100 Warner Ave Ste 100, Fountain Valley CA 92708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Devereaux, Robert Allan can be contacted via phone (714) 957-9389.

Contact Information

Primary practice address
11100 Warner Ave Ste 100 Fountain Valley CA 92708
Phone: (714) 957-9389
Fax: (714) 957-0144
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A31475 California

Profile Details

NPI number 1043264781
LBN Legal business name Devereaux, Robert Allan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Nov 29th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043264781 NPPES
California MEDICAID 00A314750

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