Individual
DR. ROBERT MATTHEW CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20162 SW BIRCH ST, SUITE 200, NEWPORT BEACH, CA 92660-0787
(949) 553-3330
(949) 631-9012
Mailing address
20162 SW BIRCH ST, SUITE 300, NEWPORT BEACH, CA 92660-0787
(949) 553-3330
(949) 631-9012
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A69851
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A698510
BLUESHIELD OF CALIFORNIA
CA
01
—
AETNA
7861689
CA
01
—
WA69851A
MEDICARE PPIN
CA
Enumeration date
02/06/2007
Last updated
05/13/2010
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