Basic Information
| Provider Information | |||||||||
| NPI: | 1497011340 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBISON | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | H | ||||||||
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| OtherLastName: | HAN | ||||||||
| OtherFirstName: | RACHAEL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 18406 ROSCOE BLVD | ||||||||
| Address2: | NORTHRIDGE FAMILY MEDICINE RESIDENCY | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188858500 | ||||||||
| FaxNumber: | 8187270793 | ||||||||
| Practice Location | |||||||||
| Address1: | 18406 ROSCOE BLVD | ||||||||
| Address2: | NORTHRIDGE FAMILY MEDICINE RESIDENCY | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188858500 | ||||||||
| FaxNumber: | 8187270793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2012 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 20A13148 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.