Organization
ROBERT K. EASTLACK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT KENNETH EASTLACK M.D. (PRESIDENT/CEO)
(858) 361-1390
Entity
Organization
Contact information
Practice address
5265 AMBER VIEW PT, SAN DIEGO, CA 92130-6933
(858) 361-1390
(858) 925-7227
Mailing address
5265 AMBER VIEW PT, SAN DIEGO, CA 92130-6933
(858) 361-1390
(858) 925-7227
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A73162
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093411900
—
MN
Enumeration date
07/03/2009
Last updated
07/03/2009
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