Provider Demographics
NPI:1023352143
Name:JAFFE, ROBERT TORIN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TORIN
Last Name:JAFFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 VOSS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-0000
Mailing Address - Country:US
Mailing Address - Phone:707-820-1035
Mailing Address - Fax:888-237-5233
Practice Address - Street 1:3000 CLEVELAND AVE STE 210
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2117
Practice Address - Country:US
Practice Address - Phone:707-820-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86528208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice