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1548252836

NPI Code Detail

MEDICARE: DR. ROBERTO LUIS RODRIGUEZ M.D.

MEDICARE: DR. ROBERTO LUIS RODRIGUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME155078	FL
2	208000000X	Pediatrics Physician	93641	GA
3	208000000X	Pediatrics Physician	65186	AZ
4	208000000X	Pediatrics Physician	A88020	CA
5	208000000X	Pediatrics Physician	MD-22303	HI
6	208000000X	Pediatrics Physician	2022002034	MO
7	208000000X	Pediatrics Physician	MD61238004	WA
8	208000000X	Pediatrics Physician	21793	NV
9	208000000X	Pediatrics Physician	MD421935	PA
10	208000000X	Pediatrics Physician	DR.0067576	CO
11	208000000X	Pediatrics Physician	M3717	TX
12	208000000X	Pediatrics Physician	D95328	MD
13	208000000X	Pediatrics Physician	036158875	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548252836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTO LUIS RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	10775 PIONEER TRL STE 215
Second Line	:
City	:	TRUCKEE
State	:	CA
Zip	:	96161-0234
Country	:	US
Telephone Number	:	415-424-4266
Fax Number	:	415-520-6633

Provider Business Practice Location Address
First Line	:	10775 PIONEER TRL STE 215
Second Line	:
City	:	TRUCKEE
State	:	CA
Zip	:	96161-0234
Country	:	US
Telephone Number	:	415-424-4266
Fax Number	:	415-520-6633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	11/04/2022

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Directions to “ DR. ROBERTO LUIS RODRIGUEZ M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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