Individual provider Active NPI

Robin Deanna Riley-Garner, PA

  • Medical Physician Assistant
  • Inglewood, CA
National Provider Identifier
1689712242
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14869 Issued in CA
Practice address
3215 W Imperial Hwy
Inglewood, CA 90303-2810
Phone
(310) 677-3595
Fax
(310) 673-5307
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14869 CA Primary

Addresses

Primary practice location

3215 W Imperial Hwy
Inglewood, CA 90303-2810

Mailing address

4353 Dawn Ave
La Verne, CA 91750-2812
Phone (909) 596-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912000557 CA Practitioner - Physician Assistant 8729011770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3215 W Imperial Hwy
Inglewood, CA 90303-2810
Phone (626) 236-6260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14869CAMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689712242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DAWN AVE",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502812",
            "telephone_number": "909-596-7474",
            "fax_number": "310-673-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 W IMPERIAL HWY",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032810",
            "telephone_number": "310-677-3595",
            "fax_number": "310-673-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY-GARNER",
        "first_name": "ROBIN",
        "middle_name": "DEANNA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.