Healthcare Provider Details

I. General information

NPI: 1043963929
Provider Name (Legal Business Name): BREANNA ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 STURGIS RD
TWENTYNINE PALMS CA
92278
US

IV. Provider business mailing address

1145 STURGIS RD
TWENTYNINE PALMS CA
92278
US

V. Phone/Fax

Practice location:
  • Phone: 760-830-2190
  • Fax:
Mailing address:
  • Phone: 760-830-2190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101279319
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: