Provider Demographics
NPI:1427229467
Name:WILCOX, ROBERT E (CPO)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:WILCOX
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3333
Mailing Address - Country:US
Mailing Address - Phone:858-292-7449
Mailing Address - Fax:858-292-5496
Practice Address - Street 1:4150 REGENTS PARK ROW
Practice Address - Street 2:SUITE 265
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-9124
Practice Address - Country:US
Practice Address - Phone:858-453-1933
Practice Address - Fax:858-453-1813
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist