NPI |
1972957546 |
The last name of the provider. If the provider is an individual, this is the legal name. |
Entity Type Code |
1 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Last Name Legal Name |
ROBINSON |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
ANN |
The first name of the provider, if the provider
is an individual. |
Provider Credential Text |
MD |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
1411 E 31ST ST |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Second Line Business Practice Location Address |
2ND FLOOR A2 |
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot
include a Post Office box. |
Provider Business Practice Location Address City Name |
OAKLAND |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
CA |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
946021018 |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
5104375039 |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
5105357313 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
4/20/2016 |
The fax number associated with the location
address of the provider being identified. |
Last Update Date |
4/20/2016 |
The date that a record was last updated or changed. |
Provider Gender Code |
F |
The date that a record was last updated or changed. |
Healthcare Provider Taxonomy Code 1 |
390200000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |