Provider Demographics
NPI:1699473165
Name:PADGETT, ROBERT (ATP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PADGETT
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 ATCHISON AVE
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2190
Mailing Address - Country:US
Mailing Address - Phone:559-531-5238
Mailing Address - Fax:
Practice Address - Street 1:2814 ATCHISON AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-2190
Practice Address - Country:US
Practice Address - Phone:559-531-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAATP84067156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist