Provider Demographics
NPI:1932252061
Name:ROBINSON, SUSAN CELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:CELINA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2471 CIELO VISTA RD
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-5213
Mailing Address - Country:US
Mailing Address - Phone:805-712-8986
Mailing Address - Fax:
Practice Address - Street 1:2471 CIELO VISTA RD
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-5213
Practice Address - Country:US
Practice Address - Phone:805-712-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0717207VG0400X
IL036.124633207VG0400X
KS04-30388207VG0400X
CAG39852207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB75137Medicare UPIN