Provider Demographics
NPI:1285646398
Name:CROW, ROBERT WADE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WADE
Last Name:CROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HEALTH SCIENCES RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-3058
Mailing Address - Country:US
Mailing Address - Phone:949-824-2020
Mailing Address - Fax:
Practice Address - Street 1:850 HEALTH SCIENCES RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-3058
Practice Address - Country:US
Practice Address - Phone:949-824-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6259385-1205207W00000X
CAA110458207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology