Healthcare Provider Details

I. General information

NPI: 1700597879
Provider Name (Legal Business Name): ANGELA M RODRIGUEZ INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 416
SAN FRANCISCO CA
94115-2379
US

IV. Provider business mailing address

2100 WEBSTER ST STE 416
SAN FRANCISCO CA
94115-2379
US

V. Phone/Fax

Practice location:
  • Phone: 520-909-4196
  • Fax: 415-228-6882
Mailing address:
  • Phone: 415-680-1120
  • Fax: 415-480-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA MORENO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 530-902-3884