Provider Demographics
NPI:1427000926
Name:WATTS, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WATTS
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 1:3001 HIGH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1860
Mailing Address - Country:US
Mailing Address - Phone:510-535-1120
Mailing Address - Fax:510-535-1228
Practice Address - Street 1:3001 HIGH ST
Practice Address - Street 2:SUITE D
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-1860
Practice Address - Country:US
Practice Address - Phone:510-535-1120
Practice Address - Fax:510-535-1228
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG332170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12263ZZMedicare UPIN