Individual
CARLOS RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
316 25TH ST, SAN DIEGO, CA 92102-3016
(619) 445-6200
Mailing address
316 25TH ST, SAN DIEGO, CA 92102-3016
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52164
CA
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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