Provider Demographics
NPI:1407900301
Name:ROBINSON, MICHAEL EUGENE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9033 BASELINE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1255
Mailing Address - Country:US
Mailing Address - Phone:909-989-4800
Mailing Address - Fax:909-989-4883
Practice Address - Street 1:9033 BASELINE RD
Practice Address - Street 2:SUITE F
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1255
Practice Address - Country:US
Practice Address - Phone:909-989-4800
Practice Address - Fax:909-989-4883
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU376231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06912ZOtherAUDIOLOGIST
CAZZZ86828ZOtherAUDIOLOGIST