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General NPI Number Information
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NPI Number | 1881409258
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Entity Type | Individual
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Provider Name | MICHELLE ANDREA RODRIGUEZ APRN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1125 N MAGNOLIA AVE
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City | ANAHEIM
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State | CA
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Zip | 92801-2604
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Country | US
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Telephone | 800-768-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 2368 HARBOR BLVD APT 105
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City | COSTA MESA
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State | CA
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Zip | 92626-6285
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Country | US
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Telephone | 661-886-8329
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 462913018
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License Number State | CA
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