Healthcare Provider Details

I. General information

NPI: 1740436278
Provider Name (Legal Business Name): ROBYN AKEMI KUROKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 LUCILE AVE #5
LOS ANGELES CA
90026-1079
US

IV. Provider business mailing address

1733 LUCILE AVENUE #5
LOS ANGELES CA
90026
US

V. Phone/Fax

Practice location:
  • Phone: 626-607-6780
  • Fax:
Mailing address:
  • Phone: 626-607-6780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA103299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: