Provider Demographics
NPI:1326030669
Name:SEMO, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SEMO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:MC 8433
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-6906
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-8585
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2012-07-05
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Provider Licenses
StateLicense IDTaxonomies
CAA42951207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A429510Medicare ID - Type Unspecified
CAC35546Medicare UPIN