Provider Demographics
NPI:1801069513
Name:MOREHEAD, ROBERT CLINTON (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLINTON
Last Name:MOREHEAD
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 1:4275 CAMPUS POINT CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1513
Mailing Address - Country:US
Mailing Address - Phone:502-939-2782
Mailing Address - Fax:
Practice Address - Street 1:4275 CAMPUS POINT CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1513
Practice Address - Country:US
Practice Address - Phone:502-939-2782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine