MEDICARE: POMAI ROBERTS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A103218	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A103218	OTHER	CA	CALIFORNIA MEDICAL BOARD

General Provider Information

NPI Number	:	1023278314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POMAI ROBERTS MD

Provider Business Mailing Address
First Line	:	1809 MYRTLE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-5205
Country	:	US
Telephone Number	:	805-754-7023
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 D AVE
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3412
Country	:	US
Telephone Number	:	619-336-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	08/13/2009

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