Provider Demographics
NPI:1861412181
Name:HINCHMAN, ROBIN RENE (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENE
Last Name:HINCHMAN
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:PO BOX 577072
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-7072
Mailing Address - Country:US
Mailing Address - Phone:209-765-5737
Mailing Address - Fax:209-543-7403
Practice Address - Street 1:4213 DALE RD STE 1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8505
Practice Address - Country:US
Practice Address - Phone:209-543-7400
Practice Address - Fax:209-543-7403
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24409111N00000X
CADC24409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0244090Medicare ID - Type Unspecified