Basic Information
| Provider Information | |||||||||
| NPI: | 1265017404 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT SIEW MD A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2926 CANADA BLVD | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912082050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6266763511 | ||||||||
| FaxNumber: | 6264860189 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 CONGRESS ST STE 155 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265215331 | ||||||||
| FaxNumber: | 6264860189 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2021 | ||||||||
| LastUpdateDate: | 03/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | SIEW | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6266763511 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.