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General NPI Number Information
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NPI Number | 1740909555
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Entity Type | Individual
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Provider Name | MS. DELIA ANN RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 3428 WILBUR ST
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City | RIVERSIDE
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State | CA
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Zip | 92503-5645
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Country | US
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Telephone | 951-450-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 9825 MAGNOLIA AVE # B198
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City | RIVERSIDE
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State | CA
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Zip | 92503-3562
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Country | US
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Telephone | 951-450-9223
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | C6978164
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License Number State | CA
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