Provider Demographics
NPI:1427177112
Name:SIEBEN, ROBERT LEONARD (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEONARD
Last Name:SIEBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-2329
Mailing Address - Country:US
Mailing Address - Phone:510-841-2746
Mailing Address - Fax:
Practice Address - Street 1:2425 EAST ST
Practice Address - Street 2:SUITE 10
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1928
Practice Address - Country:US
Practice Address - Phone:925-602-2370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG115982084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology