Basic Information
| Provider Information | |||||||||
| NPI: | 1033557608 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | SPENCER | ||||||||
| MiddleName: | S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5301 CORTEEN PL | ||||||||
| Address2: | APT 19 | ||||||||
| City: | VALLEY VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916072595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014836 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5301 CORTEEN PL | ||||||||
| Address2: | APT 19 | ||||||||
| City: | VALLEY VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916072595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014836 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2013 | ||||||||
| LastUpdateDate: | 06/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.