Organization
INNOVA PHYSICIAN NETWORK, INC.
Active
Other names
Innova Physician Network, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS G RODRIGUEZ (CEO)
(626) 398-0354
Entity
Organization
Contact information
Practice address
1403 N FAIR OAKS AVE STE 3, PASADENA, CA 91103-1876
(626) 398-0354
Mailing address
1403 N FAIR OAKS AVE STE 3, PASADENA, CA 91103-1876
(626) 398-0354
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2021
Last updated
03/11/2021
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