Healthcare Provider Details

I. General information

NPI: 1033414289
Provider Name (Legal Business Name): VICTOR ROBLES RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 SPRING HILL ST
CHINO CA
91708-7624
US

IV. Provider business mailing address

8051 SPRING HILL ST
CHINO CA
91708-7624
US

V. Phone/Fax

Practice location:
  • Phone: 909-438-1421
  • Fax:
Mailing address:
  • Phone: 909-438-1421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number00011538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: