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General NPI Number Information
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NPI Number | 1649613464
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Entity Type | Individual
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Provider Name | DOROTA KRYSTYNA RHOADS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2013
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1650 LOS GAMOS DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-1850
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Country | US
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Telephone | 415-444-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 N DOUTY ST STE 105 HANFORD FAMILY PRACTICE RESIDENCY
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City | HANFORD
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State | CA
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Zip | 93230-3722
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Country | US
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Telephone | 559-573-0226
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A137621
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License Number State | CA
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