Healthcare Provider Details

I. General information

NPI: 1750206546
Provider Name (Legal Business Name): ALVAN S ROBINSON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38345 30TH ST E STE C2
PALMDALE CA
93550-4982
US

IV. Provider business mailing address

38345 30TH ST E STE C2
PALMDALE CA
93550-4982
US

V. Phone/Fax

Practice location:
  • Phone: 909-616-7734
  • Fax:
Mailing address:
  • Phone: 909-616-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: