Basic Information
| Provider Information | |||||||||
| NPI: | 1275740102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40949 WINCHESTER RD | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925916031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512966676 | ||||||||
| FaxNumber: | 9512966675 | ||||||||
| Practice Location | |||||||||
| Address1: | 40949 WINCHESTER RD | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925916031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512966676 | ||||||||
| FaxNumber: | 9512966675 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 02/09/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 5101016925 | MI | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | DO1192 | AL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | 20A12151 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
ID Information
| ID | Type | State | Issuer | Description | 129311 | 05 | AL | MEDICAID | 051117814 | 01 | AL | BCBS | OTHER | 129313 | 05 | AL | MEDICAID | 051117813 | 01 | AL | BCBS | OTHER | 051117815 | 01 | AL | BCBS | OTHER | 129312 | 05 | AL | MEDICAID | 051117812 | 01 | AL | BCBS | OTHER | 01535013 | 05 | MS | MEDICAID | 129315 | 05 | AL | MEDICAID |