Individual
MR. JORGE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.C./C.S.T.
Contact information
Practice address
12264 EL CAMINO REAL, SUITE 101, SAN DIEGO, CA 92130-3060
(858) 847-0800
(858) 724-0450
Mailing address
12264 EL CAMINO REAL, SUITE 101, SAN DIEGO, CA 92130-3060
(858) 847-0800
(858) 724-0450
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
050842
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050842
OTC CERTIFICATION
CA
Enumeration date
12/24/2007
Last updated
12/24/2007
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