Robert Lucas Broyles, is a
Behavior Technician based in San Diego, California. Robert Lucas Broyles is licensed to practice in * (Not Available) (license number ) and his current practice location is
3731 6th Ave Ste 100, San Diego, California. He can be reached at his office (for appointments etc.) via phone at
(619) 278-0884.
NPI number for Robert Lucas Broyles is 1104473024 and his current mailing address is 16782 Von Karman Ave Ste 11, Irvine, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104473024.
Healthcare Provider's Profile
| Full Name | Robert Lucas Broyles |
|---|
| Gender | Male |
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| Speciality | Behavior Technician |
|---|
| Location | 3731 6th Ave Ste 100, San Diego, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1104473024
- Provider Enumeration Date: 08/26/2019
- Last Update Date: 01/13/2020
Medical Identifiers
Medical identifiers for Robert Lucas Broyles such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104473024 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Robert Lucas Broyles is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Robert Lucas Broyles,
16782 Von Karman Ave Ste 11,
Irvine, CA 92606-2417
Ph: (949) 833-2237 | Robert Lucas Broyles,
3731 6th Ave Ste 100,
San Diego, CA 92103-4383
Ph: (619) 278-0884 |
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