Provider Demographics
NPI:1437279882
Name:RODRIGUEZ, JEFFREY RUBEN
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:RUBEN
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15942 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2102
Mailing Address - Country:US
Mailing Address - Phone:510-846-4153
Mailing Address - Fax:
Practice Address - Street 1:8750 MOUNTAIN BLVD BLDG 69
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-4500
Practice Address - Country:US
Practice Address - Phone:510-846-4153
Practice Address - Fax:510-568-8416
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other