Provider Demographics
NPI:1275513962
Name:ROBINSON, DAVID DORMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DORMAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4265 CORRIENTE PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1658
Mailing Address - Country:US
Mailing Address - Phone:303-939-9638
Mailing Address - Fax:
Practice Address - Street 1:6550 GUNPARK DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3337
Practice Address - Country:US
Practice Address - Phone:303-581-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1131103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC94956Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER