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NPI Code Detail

MEDICARE: MS. LALA CORINA RODRIGUEZ PA-C

MEDICARE:  MS. LALA CORINA RODRIGUEZ  PA-C
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
1363A00000XPhysician Assistant51632CA

General Provider Information

NPI Number : 1316350796
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LALA CORINA RODRIGUEZ PA-C
Provider Business Mailing Address
First Line : 1030 E EL CAMINO REAL
Second Line : PMB 163
City : SUNNYVALE
State : CA
Zip : 94087-3759
Country : US
Telephone Number : 806-283-2652
Fax Number :
Provider Business Practice Location Address
First Line : 1030 E EL CAMINO REAL
Second Line : PMB 163
City : SUNNYVALE
State : CA
Zip : 94087-3759
Country : US
Telephone Number : 806-283-2652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2014
Last Update Date : 06/03/2014

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Directions to “ MS. LALA CORINA RODRIGUEZ PA-C” Practice Location

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