Provider Demographics
NPI:1053670596
Name:ROBERT HOUGHTON, M.D., INC.
Entity Type:Organization
Organization Name:ROBERT HOUGHTON, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBRITCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-233-4044
Mailing Address - Street 1:1855 1ST AVE
Mailing Address - Street 2:STE. 200B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2685
Mailing Address - Country:US
Mailing Address - Phone:619-233-4044
Mailing Address - Fax:
Practice Address - Street 1:1855 1ST AVE
Practice Address - Street 2:STE. 200B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2685
Practice Address - Country:US
Practice Address - Phone:619-233-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT HOUGHTON, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-03
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49774207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A497740Medicaid
CAF48739Medicare UPIN