Provider Demographics
NPI:1104811942
Name:LANFLISI, ROBERT ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:LANFLISI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1245 TRAVIS BLVD
Mailing Address - Street 2:#F
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4898
Mailing Address - Country:US
Mailing Address - Phone:707-426-4951
Mailing Address - Fax:707-426-4953
Practice Address - Street 1:1245 TRAVIS BLVD
Practice Address - Street 2:#F
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4898
Practice Address - Country:US
Practice Address - Phone:707-426-4951
Practice Address - Fax:707-426-4953
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG711100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G711100Medicare ID - Type Unspecified
E82173Medicare UPIN