Provider Demographics
NPI:1336590371
Name:THOMPSON, ROBIN (RPHD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 CANMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7110
Mailing Address - Country:US
Mailing Address - Phone:916-956-7864
Mailing Address - Fax:
Practice Address - Street 1:7211 ELK GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5500
Practice Address - Country:US
Practice Address - Phone:916-478-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist