Provider Demographics
NPI:1356194005
Name:MORSE, ROBERT CHARLES JR
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:MORSE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35470 MARABELLA CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8473
Mailing Address - Country:US
Mailing Address - Phone:951-233-4596
Mailing Address - Fax:
Practice Address - Street 1:35470 MARABELLA CT
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8473
Practice Address - Country:US
Practice Address - Phone:951-233-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95029530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily