Provider Demographics
NPI:1467633438
Name:P. HIRAM RODRIGUEZ D.D.S.
Entity Type:Organization
Organization Name:P. HIRAM RODRIGUEZ D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-904-1100
Mailing Address - Street 1:8847 IMPERIAL HWY STE J
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3958
Mailing Address - Country:US
Mailing Address - Phone:562-904-1100
Mailing Address - Fax:562-904-3867
Practice Address - Street 1:8847 IMPERIAL HWY STE J
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3958
Practice Address - Country:US
Practice Address - Phone:562-904-1100
Practice Address - Fax:562-904-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty