Provider Demographics
NPI:1346576469
Name:RODRIGUEZ, CAITHNESS AMY (MD)
Entity Type:Individual
Prefix:DR
First Name:CAITHNESS
Middle Name:AMY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAITHNESS
Other - Middle Name:A
Other - Last Name:VIBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14150 CULVER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0315
Mailing Address - Country:US
Mailing Address - Phone:949-857-0290
Mailing Address - Fax:949-551-5612
Practice Address - Street 1:14150 CULVER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-0315
Practice Address - Country:US
Practice Address - Phone:949-857-0290
Practice Address - Fax:949-551-5612
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine