Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G48876 | CA |
NPI | 1023014164 |
---|---|
Provider Name | Dr. Robert W Decker |
First Address | Beverly Hills, CA 90211-1850 |
Second Address | Beverly Hills, CA 90211-1850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79789 | (02) | CA |