Provider Demographics
NPI:1033571161
Name:CORDERO-PANGRAZIO, RODRIGO NICOLAS (MD)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:NICOLAS
Last Name:CORDERO-PANGRAZIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14358 CORDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5628
Mailing Address - Country:US
Mailing Address - Phone:408-476-6280
Mailing Address - Fax:
Practice Address - Street 1:14358 CORDWOOD CT
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-5628
Practice Address - Country:US
Practice Address - Phone:408-476-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA159702207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program