Healthcare Provider Details

I. General information

NPI: 1124191275
Provider Name (Legal Business Name): RODOLFO FELIX CARDENAS O.M.D. L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14600 SHERMAN WAY SUITE 300
VAN NUYS CA
91405-2283
US

IV. Provider business mailing address

9035 WOODALE AVE
ARLETA CA
91331-5826
US

V. Phone/Fax

Practice location:
  • Phone: 818-756-2519
  • Fax: 818-904-0479
Mailing address:
  • Phone: 818-504-9782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 3242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: