Healthcare Provider Details

I. General information

NPI: 1679412456
Provider Name (Legal Business Name): ROBERT KAMAU MUIRU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 N HILL AVE APT 8
PASADENA CA
91106-1251
US

IV. Provider business mailing address

621 N HILL AVE APT 8
PASADENA CA
91106-1251
US

V. Phone/Fax

Practice location:
  • Phone: 626-616-9394
  • Fax:
Mailing address:
  • Phone: 626-616-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN202319
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberVN202319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: