Provider Demographics
NPI:1114984713
Name:PERKINS, ROBERT W (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 BOLSA AVE
Mailing Address - Street 2:MAIL CODE H012-A204
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2048
Mailing Address - Country:US
Mailing Address - Phone:714-896-5181
Mailing Address - Fax:
Practice Address - Street 1:5301 BOLSA AVE
Practice Address - Street 2:MAIL CODE H012-A204
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2048
Practice Address - Country:US
Practice Address - Phone:714-896-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012229892083P0011X, 2083X0100X
CA1284122083X0100X, 2083P0011X
WAMD600656642083X0100X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine