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NPI Code Detail

MEDICARE: SAMANTHA KELSEY RODRIGUEZ MD MPH

MEDICARE:   SAMANTHA KELSEY RODRIGUEZ  MD MPH
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
1208D00000XGeneral Practice Physician1225974991CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1225974991
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA KELSEY RODRIGUEZ MD MPH
Provider Business Mailing Address
First Line : 2500 ALHAMBRA AVE
Second Line : CCRMC FAMILY MEDICINE RESIDENCY PROGRAM
City : MARTINEZ
State : CA
Zip : 94553-3156
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 ALHAMBRA AVE
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-3156
Country : US
Telephone Number : 925-370-5117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 06/10/2026

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