Provider Demographics
NPI:1164122560
Name:ROBLES, ERIC DANIEL
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DANIEL
Last Name:ROBLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10855 SCRIPPS RANCH BLVD UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2476
Mailing Address - Country:US
Mailing Address - Phone:619-942-9085
Mailing Address - Fax:
Practice Address - Street 1:10855 SCRIPPS RANCH BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2476
Practice Address - Country:US
Practice Address - Phone:619-942-9085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist