Provider Demographics
NPI:1538120944
Name:VAZQUEZ, ROBERT CLIFFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLIFFORD
Last Name:VAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-826-7575
Mailing Address - Fax:415-369-1393
Practice Address - Street 1:350 RHODE ISLAND ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5188
Practice Address - Country:US
Practice Address - Phone:415-826-7575
Practice Address - Fax:415-826-2772
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG55113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG55113OtherSTATE MEDICAL LICENSE