Provider Demographics
NPI:1649209958
Name:ROBINSON, GARY WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:WESLEY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4076 GRASS VALLEY HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-9155
Mailing Address - Country:US
Mailing Address - Phone:530-889-2225
Mailing Address - Fax:530-889-2230
Practice Address - Street 1:4076 GRASS VALLEY HWY
Practice Address - Street 2:SUITE F
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-9155
Practice Address - Country:US
Practice Address - Phone:530-889-2225
Practice Address - Fax:530-889-2230
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0200851Medicare ID - Type Unspecified