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Organization

CARLOS RODRIGUEZ CHIROPRACTIC, INC

Active
Other names
Prodigy Chiro-Care & Spinal Rehab
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARLOS CELSO RODRIGUEZ D.C. (OWNER/PRESIDENT)
(310) 899-1166
Entity
Organization

Contact information

Practice address
1511 4TH ST, SANTA MONICA, CA 90401-2310
(310) 899-1166
(310) 899-1009
Mailing address
1511 4TH ST, SANTA MONICA, CA 90401-2310
(310) 899-1166
(310) 899-1009

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC27849
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1093879583
TYPE 1 NPI #
CA
01
W18633
MEDICARE GRP #
CA
Enumeration date
02/28/2008
Last updated
02/28/2008
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