Provider Demographics
NPI:1730451022
Name:ROBERT E DORER M O T R L C H T INC
Entity type:Organization
Organization Name:ROBERT E DORER M O T R L C H T INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:DORER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MOTR/L, CHT
Authorized Official - Phone:818-841-1965
Mailing Address - Street 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-841-1965
Mailing Address - Fax:818-841-1969
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-841-1965
Practice Address - Fax:818-841-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1512225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty