Provider Demographics
NPI:1417191339
Name:ERNEST B ROBINSON MD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:ERNEST B ROBINSON MD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-831-5900
Mailing Address - Street 1:24541 PACIFIC PARK DR.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3050
Mailing Address - Country:US
Mailing Address - Phone:949-831-5900
Mailing Address - Fax:949-831-1782
Practice Address - Street 1:24541 PACIFIC PARK DR.
Practice Address - Street 2:SUITE 103
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3050
Practice Address - Country:US
Practice Address - Phone:949-831-5900
Practice Address - Fax:949-831-1782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG073812261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty