Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A43357 | CA |
NPI | 1366585986 |
---|---|
Provider Name | Dr. Ted H Robinson |
First Address | San Jose, CA 95124-4000 |
Second Address | San Jose, CA 95124-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 28/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C04021 | (02) | CA |