MEDICARE: REX L RHOTEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	A62823	CA

General Provider Information

NPI Number	:	1083792220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REX L RHOTEN M.D.

Provider Business Mailing Address
First Line	:	4510 EXECUTIVE DR STE 103
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3022
Country	:	US
Telephone Number	:	858-677-9352
Fax Number	:	858-677-9356

Provider Business Practice Location Address
First Line	:	4510 EXECUTIVE DR STE 103
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3022
Country	:	US
Telephone Number	:	858-677-9352
Fax Number	:	858-677-9356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	05/06/2022

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