MEDICARE: MRS. CAROLYN PLOU RODRIGUEZ PT, DPT

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	39214	CA

General Provider Information

NPI Number	:	1942542642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLYN PLOU RODRIGUEZ PT, DPT

Provider Business Mailing Address
First Line	:	6977 NAVAJO RD UNIT 678
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6977 NAVAJO RD UNIT 678
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1503
Country	:	US
Telephone Number	:	619-461-3887
Fax Number	:

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

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	04/21/2026

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