Individual
ROBERT WILLIAM GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6300 E. HWY 20, LUCERNE, CA 95458
(707) 274-9299
(707) 274-9297
Mailing address
10458 CHATTEN COURT, CLEARLAKE OAKS, CA 95423-7050
(707) 274-9299
(707) 274-9297
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
G30366
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G303660
—
CA
Enumeration date
11/21/2006
Last updated
11/01/2012
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