Individual
ROBERT D NORTHERN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
243 GREEN VALLEY RD STE F, FREEDOM, CA 95019-3133
(831) 763-0407
Mailing address
416B MAIN ST, SALINAS, CA 93901-3306
(831) 800-7887
(831) 998-7155
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
200560036CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
NA1788
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273942
—
OR
Enumeration date
02/08/2007
Last updated
09/23/2024
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