Provider Demographics
NPI:1487611083
Name:SKLAR, ROBERT BARRY (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BARRY
Last Name:SKLAR
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 1:31 BROWNSBURY RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-9383
Mailing Address - Country:US
Mailing Address - Phone:949-859-6600
Mailing Address - Fax:
Practice Address - Street 1:26072 MERIT CIR
Practice Address - Street 2:SUITE 119
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7015
Practice Address - Country:US
Practice Address - Phone:949-859-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42377208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADB0106OtherRAILROAD MEDICARE
CADB0106OtherRAILROAD MEDICARE
CAB45811Medicare UPIN