Provider Demographics
NPI:1942604020
Name:ROBINSON ENTERPRISE LLC
Entity Type:Organization
Organization Name:ROBINSON ENTERPRISE LLC
Other - Org Name:THE HAIR GARDEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DESHUN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-628-9808
Mailing Address - Street 1:37833 SWEET MAGNOLIA WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6799
Mailing Address - Country:US
Mailing Address - Phone:760-628-9808
Mailing Address - Fax:951-461-9101
Practice Address - Street 1:37833 SWEET MAGNOLIA WAY
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6799
Practice Address - Country:US
Practice Address - Phone:760-628-9808
Practice Address - Fax:951-461-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302F0000X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1744P3200XMedicaid
CA1744P3200XMedicare UPIN
CA1744P3200XMedicare Oscar/Certification
CA174493200XMedicare PIN