Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 35088 | CA |
NPI | 1033860549 |
---|---|
Provider Name | Melissa Edith Rodriguez |
First Address | Hayward, CA 94541-2145 |
Second Address | Hayward, CA 94541-2145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2022 |
Last Update Date | 17/01/2022 |