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NPI 1093501850

NPI 1093501850 : RODRIGO ALONSO CHAVEZ-OCHOA : CHULA VISTA, CA

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General NPI Number Information
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    NPI Number           |    1093501850
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    Entity Type          |    Individual 
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    Provider Name        |    RODRIGO ALONSO CHAVEZ-OCHOA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/17/2025
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    Last Update Date     |    04/17/2025
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Provider Practice Location Address
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    Address Line         |    1020 TIERRA DEL REY STE A-1 
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    City                 |    CHULA VISTA
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    State                |    CA
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    Zip                  |    91910-7886
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    Country              |    US
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    Telephone            |    619-585-7104
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1125 E 3RD ST 
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    City                 |    NATIONAL CITY
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    State                |    CA
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    Zip                  |    91950-1541
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    Country              |    US
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    Telephone            |    619-552-5343
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    54022
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    License Number State |    CA
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