Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 95016940 | CA |
NPI | 1164008850 |
---|---|
Provider Name | Rodney Nocon |
First Address | Los Angeles, CA 90020-1422 |
Second Address | Glendale, CA 91206-4073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2021 |
Last Update Date | 22/03/2021 |