Basic Information
| Provider Information | |||||||||
| NPI: | 1952392334 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TOMITA | ||||||||
| FirstName: | ROBIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 973 MICA DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897057255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757836190 | ||||||||
| FaxNumber: | 7757836191 | ||||||||
| Practice Location | |||||||||
| Address1: | 10509 PROFESSIONAL CIR STE 101 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895214883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753236100 | ||||||||
| FaxNumber: | 7753236118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2005 | ||||||||
| LastUpdateDate: | 05/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 9553 | NV | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | A68882 | CA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 250012514 | 01 | CA | MEDICARE RAILROAD | OTHER | 2013375 | 05 | NV | MEDICAID | CC0346 | 01 | NV | BCBS | OTHER |