Provider Demographics
NPI:1043798556
Name:RODRIGUEZ, ARTURO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15375 BARRANCA PKWY STE A103
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2203
Mailing Address - Country:US
Mailing Address - Phone:949-590-9350
Mailing Address - Fax:949-346-5350
Practice Address - Street 1:111 FASHION LN STE 210
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3306
Practice Address - Country:US
Practice Address - Phone:949-590-9350
Practice Address - Fax:714-361-2604
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295115225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist