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NPI Code Detail

MEDICARE: KATHRYN V RODRIGUEZ R.D.

MEDICARE: KATHRYN V RODRIGUEZ R.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
1133V00000XRegistered Dietitian1006544CA

General Provider Information

NPI Number : 1831526953
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN V RODRIGUEZ R.D.
Provider Business Mailing Address
First Line : 955 W IMPERIAL HWY STE 220
Second Line :
City : BREA
State : CA
Zip : 92821-3812
Country : US
Telephone Number : 714-618-9500
Fax Number :
Provider Business Practice Location Address
First Line : 4699 JAMBOREE RD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2526
Country : US
Telephone Number : 949-557-0714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2013
Last Update Date : 05/19/2024

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Directions to “ KATHRYN V RODRIGUEZ R.D.” Practice Location

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