Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | A26107 | CA |
NPI | 1093882938 |
---|---|
Provider Name | Robert L. Bender |
First Address | Pasadena, CA 91188-0001 |
Second Address | San Diego, CA 92120-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A261070 | (05) | CA |
A83330 | (02) |