Provider Demographics
NPI:1447326319
Name:GARDINER, ROBERT EMERSON (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EMERSON
Last Name:GARDINER
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 1:504 N FARRELL DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6215
Mailing Address - Country:US
Mailing Address - Phone:914-588-9226
Mailing Address - Fax:
Practice Address - Street 1:5500 UNIVERSITY PKWY
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-2318
Practice Address - Country:US
Practice Address - Phone:909-537-5241
Practice Address - Fax:909-537-7027
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG668182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry