MEDICARE: DANIEL W RHODES MD

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	2083X0100X	Occupational Medicine Physician	203210	MA

General Provider Information

NPI Number	:	1780673012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL W RHODES MD

Provider Business Mailing Address
First Line	:	457 ALAMEDA BLVD
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-1614
Country	:	US
Telephone Number	:	617-306-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	10130 SORRENTO VALLEY RD
Second Line	:	SUITE A
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1643
Country	:	US
Telephone Number	:	760-438-6572
Fax Number	:

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	11/15/2007

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