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General NPI Number Information
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NPI Number | 1174687503
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Entity Type | Individual
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Provider Name | IAN MACAULAY ROBINSON P.T.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 NEWBURY RD SUITE 210
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-6435
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Country | US
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Telephone | 805-358-0215
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Fax | 805-214-9927
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Provider Business Mailing Address
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Address Line | 638 LINDERO CANYON RD # 506
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City | OAK PARK
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State | CA
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Zip | 91377-5457
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Country | US
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Telephone | 805-358-0215
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Fax | 805-214-9927
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 15149
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License Number State | CA
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