Organization
THE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY ROBINSON M.D. (CHIEF MEDICAL OFFICER)
(323) 730-1920
Entity
Organization
Contact information
Practice address
1215 W IMPERIAL HWY STE 101, BREA, CA 92821-3738
(714) 680-8335
(714) 680-8314
Mailing address
831 W LAS PALMAS DR, FULLERTON, CA 92835-1439
(714) 403-9942
(714) 680-8314
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A064054
CA
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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