Provider Demographics
NPI:1811057086
Name:FICK, JR, ROBERT BRANDT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRANDT
Last Name:FICK, JR
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 1:240 MIMOSA WAY
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028
Mailing Address - Country:US
Mailing Address - Phone:650-233-0647
Mailing Address - Fax:650-496-1200
Practice Address - Street 1:PALO ALTO VA HEALTH CARE SYSTEM
Practice Address - Street 2:3801 MIRANDA AVENUE, PULMONARY & CCM
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94344
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75955207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease