Provider Demographics
NPI:1417174988
Name:CIFUENTES TESHIMA, RODRIGO KENNOSUKE (MD)
Entity Type:Individual
Prefix:
First Name:RODRIGO
Middle Name:KENNOSUKE
Last Name:CIFUENTES TESHIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:CA
Mailing Address - Zip Code:90201-5022
Mailing Address - Country:US
Mailing Address - Phone:323-562-6438
Mailing Address - Fax:323-562-6595
Practice Address - Street 1:7825 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:CA
Practice Address - Zip Code:90201-5022
Practice Address - Country:US
Practice Address - Phone:323-562-6438
Practice Address - Fax:323-562-6595
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89352207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology