Individual
ROBERT K EASTLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-7988
(858) 554-8231
Mailing address
FILE # 54433, LOS ANGELES, CA 90074-4433
(858) 784-5888
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
47895
MN
207X00000X
Orthopaedic Surgery Physician
Primary
A73162
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A73162
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A731620
—
CA
05
—
093411900
—
MN
Enumeration date
01/12/2006
Last updated
10/12/2011
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