MEDICARE: ABIGAIL ROBINSON

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	2255A2300X	Athletic Trainer	2000054743	CA

General Provider Information

NPI Number	:	1184376576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ROBINSON

Provider Business Mailing Address
First Line	:	3801 HOWARD AVE UNIT E
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3638
Country	:	US
Telephone Number	:	831-238-2693
Fax Number	:

Provider Business Practice Location Address
First Line	:	14325 GOLDENWEST ST
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4902
Country	:	US
Telephone Number	:	714-893-1381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	05/03/2024

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