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NPI Code Detail

MEDICARE: JUAN RODRIGUEZ NP

MEDICARE: JUAN RODRIGUEZ NP
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
1363LP0222XCritical Care Pediatric Nurse Practitioner95039953CA

General Provider Information

NPI Number : 1740114396
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN RODRIGUEZ NP
Provider Business Mailing Address
First Line : 5181 W ADAMS BLVD APT 619
Second Line :
City : LOS ANGELES
State : CA
Zip : 90016-6014
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-8358
Country : US
Telephone Number : 310-825-9111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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