Individual
EDWARD SEAN RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
I.D.M.T
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-5478
Mailing address
5029 ROWE DR, FAIRFIELD, CA 94533-6591
(707) 631-5512
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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