Provider Demographics
NPI:1952392334
Name:TOMITA, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:TOMITA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 KIETZKE LN STE 104
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2043
Mailing Address - Country:US
Mailing Address - Phone:755-348-8800
Mailing Address - Fax:833-687-1419
Practice Address - Street 1:1470 MEDICAL PKWY STE 220
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4636
Practice Address - Country:US
Practice Address - Phone:775-348-8800
Practice Address - Fax:833-687-1419
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68882208100000X
NV9553208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2013375Medicaid
CA250012514OtherMEDICARE RAILROAD
NVCC0346OtherBCBS
H08362Medicare UPIN
CA250012514OtherMEDICARE RAILROAD
NVCC0346OtherBCBS