Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G85255 | CA |
NPI | 1245389113 |
---|---|
Provider Name | Dr. Peter S. Robbins |
First Address | Redding, CA 96001-1823 |
Second Address | Redding, CA 96001-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C98901 | (02) | CA |
GR0005740 | (05) | CA |