Healthcare Provider Details

I. General information

NPI: 1457352809
Provider Name (Legal Business Name): ROBBIN CROMER-TYLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 PIONEER LN SUITE F
BISHOP CA
93514-2563
US

IV. Provider business mailing address

152 PIONEER LN SUITE F
BISHOP CA
93514-2563
US

V. Phone/Fax

Practice location:
  • Phone: 760-872-1606
  • Fax: 760-872-3463
Mailing address:
  • Phone: 760-872-1606
  • Fax: 760-872-3463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number18600
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6455
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG87935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: