Provider Demographics
NPI:1558330837
Name:ROBINSON, HARRELL E (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRELL
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 W LA VETA AVE
Mailing Address - Street 2:#810
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4225
Mailing Address - Country:US
Mailing Address - Phone:714-568-1607
Mailing Address - Fax:714-568-1618
Practice Address - Street 1:1140 W LA VETA AVE
Practice Address - Street 2:#810
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4225
Practice Address - Country:US
Practice Address - Phone:714-568-1607
Practice Address - Fax:714-568-1618
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38954207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG 038954Medicare ID - Type Unspecified