MEDICARE: ROBIN MARIE OLDENBURG NP

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
1	363LP2300X	Primary Care Nurse Practitioner	95034890	CA

General Provider Information

NPI Number	:	1598659518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN MARIE OLDENBURG NP

Provider Business Mailing Address
First Line	:	28591 HEATHER GREEN WAY
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92584-8369
Country	:	US
Telephone Number	:	951-461-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2365 NORTHSIDE DR STE 200
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-2720
Country	:	US
Telephone Number	:	951-461-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2025
Last Update Date	:	06/04/2025

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