MEDICARE: DR. ROBERT MORGAN HICKS M.D.

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	2085R0204X	Vascular & Interventional Radiology Physician	A146810	CA
2	2085R0202X	Diagnostic Radiology Physician	A146810	CA

General Provider Information

NPI Number	:	1780079699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MORGAN HICKS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6102
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94948-6102
Country	:	US
Telephone Number	:	415-884-9125
Fax Number	:	415-883-0877

Provider Business Practice Location Address
First Line	:	1501 TROUSDALE DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-696-5509
Fax Number	:	650-696-5995

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

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	04/24/2026

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