1124268461 NPI number — DR. ROBBIN L HUFF-MUSGROVE PH.D.

Table of content: DR. ROBBIN L HUFF-MUSGROVE PH.D. (NPI 1124268461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124268461 NPI number — DR. ROBBIN L HUFF-MUSGROVE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUFF-MUSGROVE
Provider First Name:
ROBBIN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124268461
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3102 E. HIGHLAND AVENUE
Provider Second Line Business Mailing Address:
MEDICAL STAFF OFFICER
Provider Business Mailing Address City Name:
PATTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-425-7679
Provider Business Mailing Address Fax Number:
909-425-6635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3102 E. HIGHLAND AVENUE
Provider Second Line Business Practice Location Address:
MEDICAL STAFF OFFICER
Provider Business Practice Location Address City Name:
PATTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-425-7679
Provider Business Practice Location Address Fax Number:
909-425-6635
Provider Enumeration Date:
02/26/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY13074 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com