Provider Demographics
NPI:1235536681
Name:TABORGA, ROBERT R (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:TABORGA
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:320 BROADWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3502
Mailing Address - Country:US
Mailing Address - Phone:619-422-0404
Mailing Address - Fax:619-422-4153
Practice Address - Street 1:1291 E MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-7201
Practice Address - Country:US
Practice Address - Phone:619-447-7774
Practice Address - Fax:619-447-7779
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA41792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist