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General NPI Number Information
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NPI Number | 1467694992
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Entity Type | Individual
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Provider Name | ARCHIBALD EDMUNDO RODRIGUEZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 1220 LA VENTA DR. #205A
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City | WEST LAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-497-8581
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Fax | 805-497-8582
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Provider Business Mailing Address
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Address Line | 638 LINDERO CYN. RD. #270
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City | OAK PARK
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State | CA
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Zip | 91377
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Country | US
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Telephone | 805-497-8581
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Fax | 805-497-8582
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 27637
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License Number State | CA
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