MEDICARE: MS. RHONDA L ROBLES OTR

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	174400000X	Specialist	3674	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3674	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1588708929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHONDA L ROBLES OTR

Provider Business Mailing Address
First Line	:	2822 E 56TH WAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2822 E 56TH WAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5112
Country	:	US
Telephone Number	:	562-633-9014
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/08/2007

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