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General NPI Number Information
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NPI Number | 1275788630
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Entity Type | Individual
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Provider Name | RODMAN A ST. CLAIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 3281 E GUASTI RD
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City | ONTARIO
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State | CA
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Zip | 91761-7622
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Country | US
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Telephone | 909-605-8015
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Fax | 866-929-7385
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Provider Business Mailing Address
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Address Line | 3281 E GUASTI RD STE 700
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City | ONTARIO
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State | CA
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Zip | 91761-7643
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Country | US
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Telephone | 909-605-8015
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Fax | 866-929-7385
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G39277
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License Number State | CA
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