Provider Demographics
NPI:1033143300
Name:BJORK, JR., ROBERT L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:BJORK, JR.
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12395 EL CAMINO REAL
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3082
Mailing Address - Country:US
Mailing Address - Phone:858-350-4901
Mailing Address - Fax:858-350-4904
Practice Address - Street 1:12395 EL CAMINO REAL
Practice Address - Street 2:SUITE 311
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3082
Practice Address - Country:US
Practice Address - Phone:858-350-4901
Practice Address - Fax:858-350-4904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA39787208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39787OtherMD LICENSE