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NPI Code Detail

MEDICARE: PAUL LAMAR ROBERSON

MEDICARE:   PAUL LAMAR ROBERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker128926CA
21041C0700XClinical Social Worker
31041S0200XSchool Social Worker

General Provider Information

NPI Number : 1285453894
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL LAMAR ROBERSON
Provider Business Mailing Address
First Line : 3850 CRENSHAW BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-1821
Country : US
Telephone Number : 323-593-5300
Fax Number :
Provider Business Practice Location Address
First Line : 2594 INDUSTRY WAY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-4015
Country : US
Telephone Number : 310-667-4070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2024
Last Update Date : 06/22/2026

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