Provider Demographics
NPI:1811916315
Name:CULVER, ROBERT P JR (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:CULVER
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N EUCLID ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4122
Mailing Address - Country:US
Mailing Address - Phone:714-991-5002
Mailing Address - Fax:714-517-2139
Practice Address - Street 1:710 N EUCLID ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4122
Practice Address - Country:US
Practice Address - Phone:714-991-5002
Practice Address - Fax:714-517-2139
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 15553363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMC0648759OtherDEA REGISTRATION NUMBER