Healthcare Provider Details

I. General information

NPI: 1922288802
Provider Name (Legal Business Name): REBECCAH RHENAE RODRIGUEZ D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 SAXONY RD
ENCINITAS CA
92024-6775
US

IV. Provider business mailing address

171 SAXONY RD
ENCINITAS CA
92024-6775
US

V. Phone/Fax

Practice location:
  • Phone: 415-713-4341
  • Fax: 415-713-4341
Mailing address:
  • Phone: 415-713-4341
  • Fax: 858-436-1289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A10913
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4720
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: