MEDICARE: LEON G ROBB MD A PROF CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	A28599	CA

General Provider Information

NPI Number	:	1023415189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEON G ROBB MD A PROF CORP

Provider Business Mailing Address
First Line	:	12840 RIVERSIDE DR
Second Line	:	SUITE 208
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3327
Country	:	US
Telephone Number	:	818-506-5197
Fax Number	:	818-506-5634

Provider Business Practice Location Address
First Line	:	12840 RIVERSIDE DR
Second Line	:	SUITE 208
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3327
Country	:	US
Telephone Number	:	818-506-5197
Fax Number	:	818-506-5634

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEON G ROBB
Credential	:	MD
Telephone Number	:	818-506-5197

Provider Enumeration Date	:	12/04/2014
Last Update Date	:	12/04/2014

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