Provider Demographics
NPI:1841436706
Name:DINENBERG, ROBERT ERIC (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ERIC
Last Name:DINENBERG
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 1:9834 GENESEE AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1223
Mailing Address - Country:US
Mailing Address - Phone:858-450-1212
Mailing Address - Fax:858-453-9271
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1223
Practice Address - Country:US
Practice Address - Phone:858-450-1212
Practice Address - Fax:858-453-9271
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-25
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80408208D00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice