Provider Demographics
NPI:1518536267
Name:C.R.DOBSON.MD., INC.
Entity type:Organization
Organization Name:C.R.DOBSON.MD., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-495-0843
Mailing Address - Street 1:1440 LINCOLN AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2628
Mailing Address - Country:US
Mailing Address - Phone:248-495-0843
Mailing Address - Fax:
Practice Address - Street 1:4510 EXECUTIVE DR STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3022
Practice Address - Country:US
Practice Address - Phone:248-495-0843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty