Provider Demographics
NPI:1194824847
Name:FOSTER, ROBERT SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:36 WEST YOKUTS AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5713
Mailing Address - Country:US
Mailing Address - Phone:209-952-3700
Mailing Address - Fax:209-478-3302
Practice Address - Street 1:36 WEST YOKUTS AVE
Practice Address - Street 2:STE 1
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5713
Practice Address - Country:US
Practice Address - Phone:209-952-3700
Practice Address - Fax:209-478-3302
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA00A23291207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A232910Medicaid
CA00A232910Medicaid
A23463Medicare UPIN
CA00A232911Medicare PIN