Provider Demographics
NPI:1740305432
Name:FOX, ROBERT I (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:I
Last Name:FOX
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 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 910
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-457-2023
Mailing Address - Fax:858-457-2721
Practice Address - Street 1:4206 CAMINITO CASSIS
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1977
Practice Address - Country:US
Practice Address - Phone:858-945-1064
Practice Address - Fax:619-615-2317
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG32029IMedicare PIN