Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | ME61470 | FL |
Y | 207RA0401X | Internist - Addiction Medicine | A44467 | CA |
NPI | 1194796151 |
---|---|
Provider Name | Dr. Robert R Treuherz |
First Address | Cedar Glen, CA 92321-0117 |
Second Address | Crestline, CA 92325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 25/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E80885 | (02) | FL |
FT6603268 | DEA (01) | CA |
XT6603268 | DEA (01) | CA |