Robert a. Mecum, M.D., Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G78258 Issued in CA

Legal business name

ROBERT A. MECUM, M.D., INC.

Practice address

1605 Euston Rd
San Marino, CA 91108-1917

Phone

(562) 789-5577

Fax

(562) 789-5567

NPI assigned

Aug 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robert A Mecum, M.D.NPI 1114945680

Title

President

Phone

(562) 789-5577

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert A Mecum, M.D.

  • Gastroenterology Physician
  • Whittier, CA
  • NPI 1114945680
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1659628758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12291 WASHINGTON BLVD STE 304",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062551",
            "telephone_number": "562-789-5577",
            "fax_number": "562-789-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 EUSTON RD",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911081917",
            "telephone_number": "562-789-5577",
            "fax_number": "562-789-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. MECUM, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "MECUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-789-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G78258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G782580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in San Marino, CA
• Providers in San Marino, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.