Healthcare Provider Details

I. General information

NPI: 1942284518
Provider Name (Legal Business Name): JOHN A ROBBINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST PSSB SUITE 2400
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

1204 39TH ST
SACRAMENTO CA
95816-5507
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7004
  • Fax: 916-734-2732
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberG34724
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: