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General NPI Number Information
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NPI Number | 1598109027
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Entity Type | Organization
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Legal Business Name | DARRYL J RODRIGUES MD INC
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 1798 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2918
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Country | US
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Telephone | 909-931-1033
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N MOUNTAIN AVE STE A104
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City | UPLAND
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State | CA
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Zip | 91786-4359
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Country | US
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Telephone | 909-931-1033
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Fax | 909-981-8976
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. DARRYL J RODRIGUES
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Credential | M.D.
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Telephone | 909-931-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G74969
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License Number State | CA
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