Provider Demographics
NPI:1295950574
Name:JAY R. ROBBINS D.C.
Entity type:Organization
Organization Name:JAY R. ROBBINS D.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-967-6461
Mailing Address - Street 1:245 W BADILLO ST STE E
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1923
Mailing Address - Country:US
Mailing Address - Phone:626-967-6461
Mailing Address - Fax:626-332-4264
Practice Address - Street 1:245 W BADILLO ST STE E
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1923
Practice Address - Country:US
Practice Address - Phone:626-967-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20369111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-3394768OtherTAX ID
CADC20369Medicare UPIN