Basic Information
Provider Information
NPI: 1174775522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARNER
FirstName: ROBIN
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1630 E MAIN ST
Address2:  
City: EL CAJON
State: CA
PostalCode: 920215204
CountryCode: US
TelephoneNumber: 8005285000
FaxNumber: 6195905155
Practice Location
Address1: 462 GRIDER ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142153021
CountryCode: US
TelephoneNumber: 7168984221
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2008
LastUpdateDate: 12/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X250388-1NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800XA106165CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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