Provider Demographics
NPI:1063879047
Name:DOUGLAS, ROBIN KIM (DC)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:KIM
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 E REMINGTON DR
Mailing Address - Street 2:STE A
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1982
Mailing Address - Country:US
Mailing Address - Phone:408-737-0730
Mailing Address - Fax:408-735-1000
Practice Address - Street 1:685 E REMINGTON DR
Practice Address - Street 2:STE A
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1982
Practice Address - Country:US
Practice Address - Phone:408-737-0730
Practice Address - Fax:408-735-1000
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor