Provider Demographics
NPI:1417367475
Name:ROBINSON, MARCUS REX (DPT)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:REX
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:MARC
Other - Middle Name:REX
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:25671 RUE DE LAC
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-8721
Mailing Address - Country:US
Mailing Address - Phone:760-855-4117
Mailing Address - Fax:
Practice Address - Street 1:1586 W SAN MARCOS BLVD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4019
Practice Address - Country:US
Practice Address - Phone:760-471-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist