# ROBERT W. OBLATH, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336330745
- **Authorized official:** JAMIE JACOBSON (BILLING MANAGER)
- **Authorized official phone:** (818) 774-1771

## Contact information

- **Practice address:** 18370 BURBANK BLVD, \#607, TARZANA, CA 91356-2804
- **Practice address phone:** (818) 774-1771
- **Practice address fax:** (818) 704-4977
- **Mailing address:** PO BOX 572913, TARZANA, CA 91357-2913
- **Mailing address phone:** (818) 774-1771
- **Mailing address fax:** (818) 704-4977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G39082 | CA | Yes |

## Other

- **Enumeration date:** 08/09/2007
- **Last updated:** 11/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G390820 | — | CA |
| 01 | — | DE8050 | MEDICARE RAILROAD | CA |
| 01 | — | WG39082E | MEDICARE ID | CA |