Provider Demographics
NPI:1497011340
Name:ROBISON, RACHAEL H
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:H
Last Name:ROBISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18406 ROSCOE BLVD
Mailing Address - Street 2:NORTHRIDGE FAMILY MEDICINE RESIDENCY
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4107
Mailing Address - Country:US
Mailing Address - Phone:818-885-8500
Mailing Address - Fax:818-727-0793
Practice Address - Street 1:18406 ROSCOE BLVD
Practice Address - Street 2:NORTHRIDGE FAMILY MEDICINE RESIDENCY
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4107
Practice Address - Country:US
Practice Address - Phone:818-885-8500
Practice Address - Fax:818-727-0793
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A13148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program