Provider Demographics
NPI:1306878582
Name:ROBERT A LEBBY MD INC
Entity type:Organization
Organization Name:ROBERT A LEBBY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEBBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-338-4799
Mailing Address - Street 1:1216 BERMUDA DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1904
Mailing Address - Country:US
Mailing Address - Phone:949-338-4799
Mailing Address - Fax:949-497-2467
Practice Address - Street 1:500 S KRAEMER BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6728
Practice Address - Country:US
Practice Address - Phone:714-930-1351
Practice Address - Fax:714-930-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69980207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W19451Medicare ID - Type Unspecified