Provider Demographics
NPI:1114650827
Name:GARCIA-RODRIGUEZ, FERNANDO (PTA)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:GARCIA-RODRIGUEZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6808 NORRIS RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-2047
Mailing Address - Country:US
Mailing Address - Phone:661-805-1348
Mailing Address - Fax:
Practice Address - Street 1:1801 OAK ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3007
Practice Address - Country:US
Practice Address - Phone:661-327-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50590208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation