Basic Information
Provider Information | |||||||||
NPI: | 1134190226 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STEELE | ||||||||
FirstName: | ROBERT | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MITOBE | ||||||||
OtherFirstName: | ROBERT | ||||||||
OtherMiddleName: | JAMES | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD MBA | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 27890 CLINTON KEITH RD | ||||||||
Address2: | SUITE D #404 | ||||||||
City: | MURRIETA | ||||||||
State: | CA | ||||||||
PostalCode: | 925628571 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7606226043 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 24745 STEWART ST | ||||||||
Address2: |   | ||||||||
City: | LOMA LINDA | ||||||||
State: | CA | ||||||||
PostalCode: | 923542751 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9095587171 | ||||||||
FaxNumber: | 9095580121 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/28/2006 | ||||||||
LastUpdateDate: | 07/16/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A76505 | CA | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 207PE0004X | A76505 | CA | Y |   | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.