Provider Demographics
NPI:1316078793
Name:ROBERT MICHAEL HUTCHMAN, M.D., INC.
Entity type:Organization
Organization Name:ROBERT MICHAEL HUTCHMAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HUTCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-654-9700
Mailing Address - Street 1:19231 VICTORY BLVD
Mailing Address - Street 2:SUITE 355N
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6308
Mailing Address - Country:US
Mailing Address - Phone:818-654-9700
Mailing Address - Fax:818-654-9600
Practice Address - Street 1:19231 VICTORY BLVD
Practice Address - Street 2:SUITE 355N
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6308
Practice Address - Country:US
Practice Address - Phone:818-654-9700
Practice Address - Fax:818-654-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA857622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A857620OtherBLUE SHIELD
G84283Medicare UPIN