MEDICARE: ROBB PAIN MANAGEMENT

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	208VP0000X	Pain Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962521948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBB PAIN MANAGEMENT

Provider Business Mailing Address
First Line	:	12840 RIVERSIDE DR
Second Line	:	SUITE 208
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12840 RIVERSIDE DR
Second Line	:	SUITE 208
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3327
Country	:	US
Telephone Number	:	310-348-0500
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	STEVEN GARRETT
Credential	:
Telephone Number	:	310-348-0500

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/22/2020

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Directions to “ROBB PAIN MANAGEMENT ” Practice Location

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