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DR. ROBERT THOMAS ENSOM M.D.
Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1265549588
Individual Registrant:DR. ROBERT THOMAS ENSOM M.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
40 E. MINARETS AVE PINEDALE, CA 93650 US
Tel: 559-436-0482 Fax: 559-436-4650
Tel: 559-436-0482 Fax: 559-436-4650
Contact information for business:
40 E MINARETS AVE FRESNO, CA 93650-1239 US
Tel: 559-436-0482 Fax: 559-436-4650
Tel: 559-436-0482 Fax: 559-436-4650
Registration Information:
NPI: 1265549588
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2084P0800X | Allopathic & Osteopathic Physicians Psychiatry & Neurology Psychiatry | CA | G45247 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NPI | 1265549588 | CA | 01 |
