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General NPI Number Information
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NPI Number | 1942604020
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Entity Type | Organization
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Legal Business Name | ROBINSON ENTERPRISE LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 37833 SWEET MAGNOLIA WAY
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City | MURRIETA
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State | CA
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Zip | 92563-6799
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Country | US
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Telephone | 760-628-9808
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Fax | 951-461-9101
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Provider Business Mailing Address
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Address Line | 37833 SWEET MAGNOLIA WAY
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City | MURRIETA
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State | CA
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Zip | 92563-6799
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Country | US
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Telephone | 760-628-9808
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Fax | 951-461-9101
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MARIA DESHUN ROBINSON
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Credential |
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Telephone | 760-628-9808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 302F0000X
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License Number State | CA
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