Provider Demographics
NPI:1700996139
Name:DEMARCO, ROBERT ARNOLD (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARNOLD
Last Name:DEMARCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7302
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-7302
Mailing Address - Country:US
Mailing Address - Phone:858-367-8660
Mailing Address - Fax:858-367-8966
Practice Address - Street 1:18025 CALLE AMBIENTE STE 204
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-9549
Practice Address - Country:US
Practice Address - Phone:858-367-8660
Practice Address - Fax:858-367-8660
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 22643111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0226431Medicare UPIN