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General NPI Number Information
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NPI Number | 1780208496
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Entity Type | Individual
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Provider Name | HORTENSIA RODRIGUEZ NP
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Gender | Female
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 25825 VERMONT AVE
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City | HARBOR CITY
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State | CA
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Zip | 90710-3518
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Country | US
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Telephone | 310-660-2569
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 N WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90029-2310
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Country | US
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Telephone | 323-957-8787
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95013407
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License Number State | CA
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