Healthcare Provider Details

I. General information

NPI: 1659395671
Provider Name (Legal Business Name): ROBERT DEAN TONKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9834 GENESEE AVE STE 225
LA JOLLA CA
92037-1215
US

IV. Provider business mailing address

9834 GENESEE AVE STE 225
LA JOLLA CA
92037-1215
US

V. Phone/Fax

Practice location:
  • Phone: 858-576-9901
  • Fax: 858-576-0080
Mailing address:
  • Phone: 858-576-9901
  • Fax: 858-576-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA46158
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA46158
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberA46158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: