MEDICARE: DR. PAVEL RODRIGUEZ MD

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	2085R0202X	Diagnostic Radiology Physician	304722	NY
2	2085N0700X	Neuroradiology Physician	304722	NY
3	2085R0202X	Diagnostic Radiology Physician	1988-320	WI
4	2085R0202X	Diagnostic Radiology Physician	Q1484	TX
5	2085N0700X	Neuroradiology Physician	MD459016	PA
6	2085N0700X	Neuroradiology Physician	A180411	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1922391796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAVEL RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	43 BETHANY DR
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92603-3544
Country	:	US
Telephone Number	:	210-618-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	27999 MEDICAL CENTER
Second Line	:	SUITE 200
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691
Country	:	US
Telephone Number	:	951-365-1841
Fax Number	:	949-482-2644

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

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	12/12/2025

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