Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | CA |
NPI | 1033557608 |
---|---|
Provider Name | Spencer S. Robinson |
First Address | Valley Village, CA 91607-2595 |
Second Address | Valley Village, CA 91607-2595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 05/06/2013 |