Healthcare Provider Details

I. General information

NPI: 1053008193
Provider Name (Legal Business Name): ROBERT MARK COBO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13657 W MCDOWELL RD STE 220
GOODYEAR AZ
85395-2603
US

IV. Provider business mailing address

13657 W MCDOWELL RD STE 220
GOODYEAR AZ
85395-2603
US

V. Phone/Fax

Practice location:
  • Phone: 623-848-5609
  • Fax:
Mailing address:
  • Phone: 623-848-5609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number011658
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: