Provider Demographics
NPI:1063557072
Name:ADAMS, ROBERT EUGENE (PT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EUGENE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10943 ALTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3904
Mailing Address - Country:US
Mailing Address - Phone:323-899-1371
Mailing Address - Fax:323-650-3586
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-385-9064
Practice Address - Fax:310-385-9264
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT-24995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist