| Robert J. Giombetti M.d. | |
|
4560 Admiralty Way Ste 352 Marina Del Rey CA 90292-5448 | |
| (310) 306-8876 | |
| (310) 822-3313 |
| Full Name | Robert J. Giombetti M.d. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4560 Admiralty Way Ste 352, Marina Del Rey, California |
| Authorized Official Name and Position | Robert J Giombetti (CEO) |
| Authorized Official Contact | 3103068876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert J. Giombetti M.d. 4560 Admiralty Way Ste 352 Marina Del Rey CA 90292-5448 Ph: (310) 306-8876 | Robert J. Giombetti M.d. 4560 Admiralty Way Ste 352 Marina Del Rey CA 90292-5448 Ph: (310) 306-8876 |
| NPI Number | 1447833405 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 09/14/2021 |
| Certification Date | 09/14/2021 |
| Medicare PECOS PAC ID | 9638567753 |
|---|---|
| Medicare Enrollment ID | O20211022000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447833405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0301X | Psychiatry & Neurology - Brain Injury Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric Gim Lee |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245337872 PECOS PAC ID: 3779481262 Enrollment ID: I20031222000445 |
| Provider Name | Robert Joseph Giombetti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659445211 PECOS PAC ID: 3971498783 Enrollment ID: I20100727000965 |
| Provider Name | Silica D Bungabong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104293067 PECOS PAC ID: 2466730478 Enrollment ID: I20180613000645 |
| Provider Name | Eric Gim Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245337872 PECOS PAC ID: 3779481262 Enrollment ID: I20220914001014 |
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