Provider Demographics
NPI:1467993790
Name:BALTAXE, ROBIN CARUSO (MPH ALL COURSES PHD)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:CARUSO
Last Name:BALTAXE
Suffix:
Gender:F
Credentials:MPH ALL COURSES PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 E SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-2926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2675 E SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2926
Practice Address - Country:US
Practice Address - Phone:323-589-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator