Individual
FAUSTO JOSE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVE RM 18170B, LOS ANGELES, CA 90095-0010
(310) 206-5008
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8771
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C173820
MD
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
46086
MN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
C173820
MD
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
D71393
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038455100
—
MD
05
—
540628500
—
MN
Enumeration date
02/02/2006
Last updated
11/29/2021
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