Provider Demographics
NPI:1871503433
Name:ROBINSON, MAGDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDA
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1738 N WATERMAN AVE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:SAN BERNANDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404
Mailing Address - Country:US
Mailing Address - Phone:909-882-1269
Mailing Address - Fax:909-882-5699
Practice Address - Street 1:1738 N WATERMAN AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:SAN BERNANDINO
Practice Address - State:CA
Practice Address - Zip Code:92404
Practice Address - Country:US
Practice Address - Phone:909-882-1269
Practice Address - Fax:909-882-5699
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA052460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A524600Medicaid
CA1871503433OtherNPI
522348272OtherTAX ID
CA00A524600Medicaid
OOA524601Medicare ID - Type Unspecified