Provider Demographics
NPI:1114957941
Name:ALLEYNE, ROBIN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANDREW
Last Name:ALLEYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 BALBOA BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5810
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-654-3417
Practice Address - Street 1:7512 MORRO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4404
Practice Address - Country:US
Practice Address - Phone:805-792-1400
Practice Address - Fax:805-792-1485
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70593FMedicaid
CAW1508COtherMEDICARE GROUP'S PTAN-ATASCADERO
CABG280YOtherPTAN: TEMPLETON
CAW1508AOtherMEDICARE GROUP'S PTAN TEMPLETON
CA1275550295OtherPTAN: TEMPLETON BG280Y NPI#
CAFHC70593FMedicaid
CAW1508COtherMEDICARE GROUP'S PTAN-ATASCADERO