Provider Demographics
NPI:1275745879
Name:NAVIAUX, ROBERT KEITH (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KEITH
Last Name:NAVIAUX
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 DICKINSON STREET
Mailing Address - Street 2:BLDG CTF, ROOM C103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8467
Mailing Address - Country:US
Mailing Address - Phone:619-543-2904
Mailing Address - Fax:619-543-7868
Practice Address - Street 1:214 DICKINSON STREET
Practice Address - Street 2:BLDG CTF, ROOM C103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8467
Practice Address - Country:US
Practice Address - Phone:619-543-2904
Practice Address - Fax:619-543-7868
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61267170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics