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General NPI Number Information
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NPI Number | 1932320546
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Entity Type | Individual
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Provider Name | JOHN RODRIGUEZ ONOFRE PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7301 STATE STREET
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255
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Country | US
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Telephone | 323-581-5120
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Fax | 323-581-5148
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Provider Business Mailing Address
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Address Line | 9325 DALEWOOD AVE
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City | DOWNEY
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State | CA
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Zip | 90240
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Country | US
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Telephone | 562-659-1161
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-14766
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License Number State | CA
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