Provider Demographics
NPI:1164971487
Name:RODRIGUEZ, CARLOS J (DPM, MS, PA)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:J
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DPM, MS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0631
Mailing Address - Country:US
Mailing Address - Phone:661-324-4100
Mailing Address - Fax:661-324-4600
Practice Address - Street 1:5020 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0631
Practice Address - Country:US
Practice Address - Phone:661-324-4100
Practice Address - Fax:661-324-4600
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3862213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery