Provider Demographics
NPI:1427248491
Name:ROBIN K DORE MD INC
Entity type:Organization
Organization Name:ROBIN K DORE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-505-5500
Mailing Address - Street 1:18102 IRVINE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3423
Mailing Address - Country:US
Mailing Address - Phone:714-505-5500
Mailing Address - Fax:714-505-3381
Practice Address - Street 1:18102 IRVINE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3423
Practice Address - Country:US
Practice Address - Phone:714-505-5500
Practice Address - Fax:714-505-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33113207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15069Medicare PIN