Provider Demographics
NPI:1912977554
Name:HOWARD, ROBERT MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:HOWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8022 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1615
Mailing Address - Country:US
Mailing Address - Phone:858-278-3937
Mailing Address - Fax:858-278-3996
Practice Address - Street 1:8022 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1615
Practice Address - Country:US
Practice Address - Phone:858-278-3937
Practice Address - Fax:858-278-3996
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6960T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U76548Medicare UPIN
CABW327AMedicare PIN