Individual
TAJIA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1290 TAVERN RD, MAMMOTH LAKES, CA 93546-6601
(760) 924-1740
Mailing address
PO BOX 2619, MAMMOTH LAKES, CA 93546-2619
(760) 924-1740
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-OPGUMY
CA
Other
Enumeration date
08/23/2022
Last updated
11/29/2023
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