Robert B Pollack, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

G067551 Issued in CA

Practice address

4510 Executive Dr.
Suite 105
San Diego, CA 92121-3022

Phone

(858) 457-8686

Fax

(858) 450-7690

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1487653523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR.",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213022",
            "telephone_number": "858-457-8686",
            "fax_number": "858-450-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR.",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213022",
            "telephone_number": "858-457-8686",
            "fax_number": "858-450-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "ROBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G067551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G675510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary C. Polkoski, PA-C
• Andrew Pollack, LAC
• Daniell Bennett Pollack, PA-C
• Jobeth Pollack, RN
• Larry Howard Pollack, M.D.
• Rory Pollack
• Sandra Hop Pollack
• Brandon Ames Pollak, M.D.
• Agnieszka Pollard, PHD
• Emma Pollard

• Plastic and Reconstructive Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.