Individual provider Active NPI

Robert Keith Naviaux, M.D., PH.D.

  • Ph.D. Medical Genetics
  • San Diego, CA
National Provider Identifier
1275745879
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
G61267 Issued in CA
Practice address
214 Dickinson Street
BLDG CTF, Room C103
San Diego, CA 92103-8467
Phone
(619) 543-2904
Fax
(619) 543-7868
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X G61267 CA Primary

Addresses

Primary practice location

214 Dickinson Street
BLDG CTF, Room C103
San Diego, CA 92103-8467

Mailing address

214 Dickinson Street
BLDG CTF, Room C103
San Diego, CA 92103-8467
Phone (619) 543-2904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
G61267CAMDPh.D. Medical Genetics

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275745879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 DICKINSON STREET",
            "address_2": "BLDG CTF, ROOM C103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038467",
            "telephone_number": "619-543-2904",
            "fax_number": "619-543-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 DICKINSON STREET",
            "address_2": "BLDG CTF, ROOM C103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038467",
            "telephone_number": "619-543-2904",
            "fax_number": "619-543-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVIAUX",
        "first_name": "ROBERT",
        "middle_name": "KEITH",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "G61267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.