Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A99037 | CA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D70424 | MD |
NPI | 1073726444 |
---|---|
Provider Name | Dr. Krista Michelle Rodriguez-Bruno |
First Address | La Jolla, CA 92037-1264 |
Second Address | La Jolla, CA 92037-1264 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 21/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037375300 | (05) | MD |