Individual
MR. GILBERTO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
43520 DIVISION STREET, LANCASTER, CA 93535
(661) 266-4783
(661) 266-1210
Mailing address
43520 DIVISION STREET, LANCASTER, CA 93535
(661) 266-4783
(661) 266-1210
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#95-2633765
MEDI-CAL
CA
Enumeration date
11/08/2012
Last updated
04/25/2024
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