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General NPI Number Information
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NPI Number | 1912212739
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Entity Type | Organization
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Legal Business Name | OWEN L. ROBINSON MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 1141 W REDONDO BEACH BLVD STE 400
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-538-1381
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Fax | 310-538-4900
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD STE 400
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-538-1381
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Fax | 310-538-4900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OWEN ROBINSON
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Credential | M.D.
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Telephone | 310-538-1381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G47920
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License Number State | CA
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