Healthcare Provider Details

I. General information

NPI: 1720377880
Provider Name (Legal Business Name): MR. COLIN LAWRENCE ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11633 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3513
US

IV. Provider business mailing address

11633 VICTORY BLVD
NORTH HOLLYWOOD CA
91606-3513
US

V. Phone/Fax

Practice location:
  • Phone: 800-851-0966
  • Fax: 833-471-5322
Mailing address:
  • Phone: 800-851-0955
  • Fax: 833-471-5322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA123689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: