Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | G84678 | CA |
NPI | 1316929565 |
---|---|
Provider Name | Dr. Anne O. Rodriguez |
First Address | Ventura, CA 93003-2909 |
Second Address | Ventura, CA 93003-2909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 26/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G846780 | (05) | CA |
G74673 | (02) | CA |