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General NPI Number Information
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NPI Number | 1750961843
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Entity Type | Individual
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Provider Name | MARSHALL C ROBERTS MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 16899 W BERNARDO DR
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City | SAN DIEGO
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State | CA
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Zip | 92127-1603
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Country | US
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Telephone | 858-499-2705
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Fax |
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Provider Business Mailing Address
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Address Line | 16899 W BERNARDO DR
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City | SAN DIEGO
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State | CA
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Zip | 92127-1603
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A189192
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License Number State | CA
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