Provider Demographics
NPI:1215235999
Name:ROBERT AMSTER MD-EASTLAKE INC
Entity type:Organization
Organization Name:ROBERT AMSTER MD-EASTLAKE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:AMSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-389-5700
Mailing Address - Street 1:18231 IRVINE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3432
Mailing Address - Country:US
Mailing Address - Phone:714-389-5700
Mailing Address - Fax:714-389-6973
Practice Address - Street 1:18231 IRVINE BLVD
Practice Address - Street 2:STE A
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3432
Practice Address - Country:US
Practice Address - Phone:714-389-5700
Practice Address - Fax:714-389-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34265207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty