Provider Demographics
NPI:1760544258
Name:ROBINSON, AMY A (PT, MPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:A
Other - Last Name:BYNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:24630 WASHINGTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6131
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:31764 CASINO DR
Practice Address - Street 2:SUITE 106
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4571
Practice Address - Country:US
Practice Address - Phone:951-471-3300
Practice Address - Fax:951-471-3301
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA230618Medicare PIN
CACA230621Medicare PIN
CACA230619Medicare PIN
CACA230616Medicare PIN
CACA230620Medicare PIN
CACA230622Medicare PIN
CACA230617Medicare PIN