Individual
ELIJAH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
892 27TH ST, SAN DIEGO, CA 92154-1444
(619) 575-4687
Mailing address
156 CYPRESS ST, CHULA VISTA, CA 91910-2932
(619) 395-7195
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
719344
CA
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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