MEDICARE: ROSSY RENDON

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	225100000X	Physical Therapist	309387	CA

General Provider Information

NPI Number	:	1700749280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSSY RENDON

Provider Business Mailing Address
First Line	:	4332 CAMINITO DEL ZAFIRO
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1906
Country	:	US
Telephone Number	:	760-261-9814
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 CARMEL MOUNTAIN RD STE 208B
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-4861
Country	:	US
Telephone Number	:	760-261-9814
Fax Number	:

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

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ ROSSY RENDON ” Practice Location

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