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General NPI Number Information
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NPI Number | 1245529056
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Entity Type | Individual
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Provider Name | ROBERT JOSPEH CLAYCOMB M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 10666 N TORREY PINES RD # MS 313
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City | LA JOLLA
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State | CA
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Zip | 92037-1027
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Country | US
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Telephone | 860-997-4815
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 E VISTA CHINO # A7-465
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City | PALM SPRINGS
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State | CA
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Zip | 92262-3559
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Country | US
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Telephone | 860-997-4815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A136339
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License Number State | CA
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