Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E3710 | CA |
N | 111NR0200X | Radiology | RHD 134777 | CA |
N | 213ER0200X | Radiology | RHD 134777 | CA |
N | 2081S0010X | Sports Medicine | E3710 | CA |
N | 213ES0000X | Sports Medicine | E3710 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E3710 | CA |
N | 213ES0131X | Foot Surgery | E3710 | CA |
NPI | 1003911900 |
---|---|
Provider Name | Dr. Robert Gustave Lawson |
First Address | Escondido, CA 92025-4116 |
Second Address | Poway, CA 92064-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 04/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E37100 | (05) | CA |
480018837 | RAILROAD MEDICARE (01) | CA |
T97055 | (02) | CA |