Provider Demographics
NPI:1245233147
Name:ESTRELLA-ITCHON, RHODA GALINATO (MD)
Entity Type:Individual
Prefix:DR
First Name:RHODA
Middle Name:GALINATO
Last Name:ESTRELLA-ITCHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25495 MEDICAL CENTER DR.
Mailing Address - Street 2:STE 301
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4904
Mailing Address - Country:US
Mailing Address - Phone:951-461-1070
Mailing Address - Fax:951-461-3449
Practice Address - Street 1:25495 MEDICAL CENTER DR.
Practice Address - Street 2:STE 301
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4904
Practice Address - Country:US
Practice Address - Phone:951-461-1070
Practice Address - Fax:951-461-3449
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6723134Medicaid
A55570Medicare ID - Type Unspecified
CA6723134Medicaid