Individual
MR. DESHAWN MICHAEL ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10515 BALBOA BLVD, SUITE 285, GRANADA HILLS, CA 91344-6343
(619) 820-7062
Mailing address
10515 BALBOA BLVD, SUITE 285, GRANADA HILLS, CA 91344-6343
(619) 820-7062
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
54384
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
03/10/2015
Last updated
05/03/2017
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