Healthcare Provider Details

I. General information

NPI: 1114306479
Provider Name (Legal Business Name): BARBARA RODRIGUEZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMRTC SAN DIEGO 34800 BOB WILSON DR
SAN DIEGO CA
92134
US

IV. Provider business mailing address

NMRTC SAN DIEGO 34800 BOB WILSON DR
SAN DIEGO CA
92134
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-6666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA59751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: