Provider Demographics
NPI:1083720692
Name:WELCH, ROBIN WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:WILLIAM
Last Name:WELCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 S EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1523
Mailing Address - Country:US
Mailing Address - Phone:714-535-1404
Mailing Address - Fax:714-535-1497
Practice Address - Street 1:980 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1523
Practice Address - Country:US
Practice Address - Phone:714-535-1404
Practice Address - Fax:714-535-1497
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC18170Medicare ID - Type Unspecified