Provider Demographics
NPI:1215147533
Name:FOX, ROBERT A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3534 SANTA CARLOTTA ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1115
Mailing Address - Country:US
Mailing Address - Phone:818-957-1652
Mailing Address - Fax:818-957-4672
Practice Address - Street 1:3534 SANTA CARLOTTA ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91214-1115
Practice Address - Country:US
Practice Address - Phone:818-957-1652
Practice Address - Fax:818-957-4672
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG32218208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG32219OtherLICENSE
CAG32219OtherLICENSE