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Individual

BARRY NEAL RODGVELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1360 W 6TH ST, SUITE 240, SAN PEDRO, CA 90732-3589
(310) 548-3311
(310) 548-3384
Mailing address
1360 W 6TH ST, SUITE 240, SAN PEDRO, CA 90732-3589
(310) 548-3311
(310) 548-3384

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E1681
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E16810
CA
Enumeration date
10/25/2005
Last updated
06/24/2008
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