Robert William Henderson Jr, M.D.

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

G25042 Issued in CA

Practice address

1520 San Pablo St # 1600
Los Angeles, CA 90033-5310

Phone

(323) 442-8541

Fax

(323) 442-8755

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Advance Bioimaging Associates

  • Nuclear Radiology Physician
  • Los Angeles, CA
  • NPI 1306899695
  NPD (past)
• Usc Cardiothoracic Surgeon'S

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Los Angeles, CA
  • NPI 1457364507
  NPD (past)
• Usc Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1114971629
  NPD (past)
• Usc Radiology Associates, Inc

  • Body Imaging Physician
  • Los Angeles, CA
  • NPI 1225089865

  Nuclear Radiology

  NPD (past)
• Verdugo Hills Pharmacy Inc

  • Community/Retail Pharmacy
  • Glendale, CA
  • NPI 1144615550
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1427083195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST # 1600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON JR",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "G25042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL OPTIMA",
            "identifier": "00G250420G56",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G250420",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "300046333",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G250420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Lesbia Henao
• Evelyn Henar, MD
• Jeffrey Hendel, M.D.
• Moshe Hendeles, RBT
• Christman Donaldson Henderer, DMD
• Myriah Henderson-Baskin
• Asia Henderson-Moore
• Alex Fitzgerald Henderson
• Anamarie Henderson
• Andrea Lynne Henderson, D.D.S, F.A.C.P

• Nuclear Radiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nuclear Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.