Provider Demographics
NPI:1003957101
Name:ROBINSON, ROSE DARLENE (DC, L AC)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:DARLENE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3333
Mailing Address - Country:US
Mailing Address - Phone:310-559-0525
Mailing Address - Fax:310-559-2265
Practice Address - Street 1:2510 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3333
Practice Address - Country:US
Practice Address - Phone:310-559-0525
Practice Address - Fax:310-559-2265
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3463171100000X
CADC18612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered111N00000XChiropractic ProvidersChiropractor