Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A82639 | CA |
NPI | 1013059385 |
---|---|
Provider Name | Dr. Javier Rodriguez |
First Address | San Diego, CA 92105-1608 |
Second Address | San Diego, CA 92105-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 22/02/2019 |