Healthcare Provider Details

I. General information

NPI: 1104941434
Provider Name (Legal Business Name): ROBERT GEORGE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7744 FAY AVE SUITE 100
LA JOLLA CA
92037-4313
US

IV. Provider business mailing address

7744 FAY AVE SUITE 100
LA JOLLA CA
92037-4313
US

V. Phone/Fax

Practice location:
  • Phone: 858-459-0180
  • Fax: 858-504-0595
Mailing address:
  • Phone: 858-459-0180
  • Fax: 858-504-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC13319
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC13319
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC13319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: