Individual
DR. RODOLFO ARCOVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
786 3RD AVE, #B, CHULA VISTA, CA 91910-5826
(619) 425-0797
Mailing address
786 3RD AVE, SUITE B, CHULA VISTA, CA 91910
(619) 425-0797
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
651718
CA
208600000X
Surgery Physician
C51718
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C51718
—
CA
01
—
33-0618203
TAX IDENTIFICATION
CA
01
—
GROO62500
GROUP MEDICAID #
CA
Enumeration date
01/19/2006
Last updated
03/05/2015
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