Basic Information
| Provider Information | |||||||||
| NPI: | 1023415189 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEON G ROBB MD A PROF CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12840 RIVERSIDE DR | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | NORTH HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916073327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185065197 | ||||||||
| FaxNumber: | 8185065634 | ||||||||
| Practice Location | |||||||||
| Address1: | 12840 RIVERSIDE DR | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | NORTH HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916073327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185065197 | ||||||||
| FaxNumber: | 8185065634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2014 | ||||||||
| LastUpdateDate: | 12/04/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROBB | ||||||||
| AuthorizedOfficialFirstName: | LEON | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8185065197 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | A28599 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.