Provider Demographics
NPI:1073831236
Name:THOMAS-ROBINSON, TINA DENISE (PA-C)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:DENISE
Last Name:THOMAS-ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2480 MISSION ST
Mailing Address - Street 2:SUITE #331
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2468
Mailing Address - Country:US
Mailing Address - Phone:415-282-6490
Mailing Address - Fax:415-282-6491
Practice Address - Street 1:2480 MISSION ST
Practice Address - Street 2:SUITE #331
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2468
Practice Address - Country:US
Practice Address - Phone:415-282-6490
Practice Address - Fax:415-282-6491
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19906363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant