Organization
BILLY RODRIGUEZ CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUILLERMO RODRIGUEZ JR. D.C. (PRESIDENT/OWNER)
(951) 485-6300
Entity
Organization
Contact information
Practice address
12981 PERRIS BLVD, SUITE 106, MORENO VALLEY, CA 92553-4102
(951) 485-6300
(951) 485-6322
Mailing address
12981 PERRIS BLVD, SUITE 106, MORENO VALLEY, CA 92553-4102
(951) 485-6300
(951) 485-6322
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 29988
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891869657
INDIVIDUAL NPI
CA
01
—
DA127A
GROUP PTAN
CA
01
—
DA128Z
INDIVIDUAL PTAN
CA
01
—
DC29988
CHIROPRACTIC LICENSE
CA
Enumeration date
10/28/2008
Last updated
03/13/2018
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