Individual
DOMINIC RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-7003
Mailing address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-7003
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
31994
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31994
RESPIRATORY CARE BOARD OF CALIFORNIA
CA
01
—
B5301251
DRIVER LIC
CA
Enumeration date
08/16/2018
Last updated
08/16/2018
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