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General NPI Number Information
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NPI Number | 1972595882
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Entity Type | Individual
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Provider Name | JEFFREY M RODNICK MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 2900 LOMA VISTA RD STE 100
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City | VENTURA
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State | CA
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Zip | 93003-2920
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Country | US
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Telephone | 805-648-5191
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Fax | 805-648-3458
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Provider Business Mailing Address
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Address Line | 2900 LOMA VISTA RD STE 100
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City | VENTURA
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State | CA
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Zip | 93003-2909
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Country | US
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Telephone | 805-648-5191
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Fax | 805-348-3458
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | G58325
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License Number State | CA
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