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Contact Information

KEVIN C ROBERTSON, PA
125 EUCALYPTUS DR
EL SEGUNDO, CA90245-3839
 Phone: 310-322-4278
 Fax: 310-322-6660
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KEVIN C ROBERTSON · (Male)

NPI # 1295955441
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 04/30/2007
Last updated 08/14/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA17110
  • CA Other PA17110 MEDICAL LICENSE
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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