Provider Demographics
NPI:1073687620
Name:ROBERT I FOX, MD, INC.
Entity Type:Organization
Organization Name:ROBERT I FOX, MD, INC.
Other - Org Name:ROBERT I FOX, MD, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:858-456-0559
Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 910
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-457-2023
Mailing Address - Fax:858-457-2721
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:#910
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-457-2023
Practice Address - Fax:858-457-2721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW21584Medicare PIN