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NPI 1457467094

NPI 1457467094 : DAVID WAYNE RHODES MD : ALTADENA, CA

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General NPI Number Information
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    NPI Number           |    1457467094
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID WAYNE RHODES MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/23/2006
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    Last Update Date     |    03/17/2018
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Provider Practice Location Address
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    Address Line         |    2124 MIDLOTHIAN DR 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-3414
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    Country              |    US
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    Telephone            |    626-798-7042
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2124 MIDLOTHIAN DR 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-3414
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    Country              |    US
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    Telephone            |    626-798-7042
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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        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    C34195
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    License Number State |    CA
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