Provider Demographics
NPI:1063537371
Name:ROBERT A. ROVNER MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ROBERT A. ROVNER MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROVNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-708-0300
Mailing Address - Street 1:1320 EL CAPITAN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6258
Mailing Address - Country:US
Mailing Address - Phone:925-275-0700
Mailing Address - Fax:925-275-0701
Practice Address - Street 1:1320 EL CAPITAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-6258
Practice Address - Country:US
Practice Address - Phone:925-275-0700
Practice Address - Fax:925-275-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42980207XS0114X, 207X00000X, 207XP3100X, 207XX0005X, 207XX0801X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G429800Medicaid
CA00G249800Medicare UPIN
CAA49182Medicare UPIN