Provider Demographics
NPI:1831523737
Name:BENNETT, ROBIN ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16130 JUAN HERNANDEZ DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5527
Mailing Address - Country:US
Mailing Address - Phone:408-871-3400
Mailing Address - Fax:408-871-5214
Practice Address - Street 1:16130 JUAN HERNANDEZ DR STE 104
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5527
Practice Address - Country:US
Practice Address - Phone:408-871-3400
Practice Address - Fax:408-871-5214
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine