| Doctor Name: | DR. ROBERT DERGALUST |
| NPI Number: | 1023190782 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A50099 |
| Business Practice Address: | 133 W Santa Clara St Medical Specialties Clinic Ventura, CA - 930012543 |
| Business Phone Number: | 8056415694 |
| Business Fax Number: | 8056415695 |
| Mailing Address: | 2483 Michael Dr, NEWBURY PARK |
| State: | CA |
| Postal Code: | 913203234 |
| Phone Number: | 8188651633 |
| Fax Number: | 8188651633 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084N0600X |
| License Number: | A50099 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Clinical Neurophysiology |
| Taxonomy Definition: | Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |