Provider Demographics
NPI:1619972510
Name:DORE, ROBIN K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:K
Last Name:DORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12791 NEWPORT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2751
Mailing Address - Country:US
Mailing Address - Phone:714-505-5500
Mailing Address - Fax:714-505-3381
Practice Address - Street 1:12791 NEWPORT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2751
Practice Address - Country:US
Practice Address - Phone:714-505-5500
Practice Address - Fax:714-505-3381
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2012-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG33113207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45431Medicare UPIN