Provider Demographics
NPI:1063418259
Name:PATTERSON, ROBERT STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
Last Name:PATTERSON
Suffix:
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 1:17322 MARTHA ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1319
Mailing Address - Country:US
Mailing Address - Phone:818-349-6060
Mailing Address - Fax:818-960-0214
Practice Address - Street 1:5567 RESEDA BLVD
Practice Address - Street 2:STE 106
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2648
Practice Address - Country:US
Practice Address - Phone:818-349-6060
Practice Address - Fax:818-960-0214
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25167111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician