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NPI Code Detail

MEDICARE: DR. GEORGE G. RODRIGUEZ D.C.

MEDICARE: DR. GEORGE G. RODRIGUEZ D.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
1111N00000XChiropractorDC14741CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DC14741OTHERCALICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376752766
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE G. RODRIGUEZ D.C.
Provider Business Mailing Address
First Line : 3612 E 1ST ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-2326
Country : US
Telephone Number : 323-264-9163
Fax Number : 323-264-9847
Provider Business Practice Location Address
First Line : 3612 E 1ST ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-2326
Country : US
Telephone Number : 323-264-9163
Fax Number : 323-264-9847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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