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NPI Code Detail

MEDICARE: RODRIGO CARRILLO KOH

MEDICARE: RODRIGO CARRILLO KOH
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1851224398
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODRIGO CARRILLO KOH
Provider Business Mailing Address
First Line : 23830 NEWHALL AVE SPC 46
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91321-3157
Country : US
Telephone Number : 661-268-2377
Fax Number :
Provider Business Practice Location Address
First Line : 24355 LYONS AVE STE 240
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91321-2390
Country : US
Telephone Number : 661-498-9940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ RODRIGO CARRILLO KOH ” Practice Location

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