Healthcare Provider Details
I. General information
NPI: 1194808287
Provider Name (Legal Business Name): RODNEY LLOYD CUMMINGS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/23/2006
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26045 BOUQUET CANYON RD
SAUGUS CA
91350-2639
US
IV. Provider business mailing address
26045 BOUQUET CANYON RD
SAUGUS CA
91350-2639
US
V. Phone/Fax
- Phone: 661-254-6107
- Fax: 661-255-2805
- Phone: 661-254-6107
- Fax: 661-255-2805
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC17084 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: