MEDICARE: DAVID BOBROW, M.D., A MEDICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1285727222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID BOBROW, M.D., A MEDICAL CORP

Provider Business Mailing Address
First Line	:	4103 1ST AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2024
Country	:	US
Telephone Number	:	619-871-8463
Fax Number	:

Provider Business Practice Location Address
First Line	:	4103 1ST AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2024
Country	:	US
Telephone Number	:	619-871-8463
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID BOBROW
Credential	:	MD
Telephone Number	:	619-871-1347

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/10/2020

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