Provider Demographics
NPI:1588676472
Name:RODRIGUEZ, ANGELA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 750
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94942-0750
Mailing Address - Country:US
Mailing Address - Phone:156-801-1120
Mailing Address - Fax:415-228-6882
Practice Address - Street 1:2100 WEBSTER ST STE 416
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2379
Practice Address - Country:US
Practice Address - Phone:415-680-1120
Practice Address - Fax:415-480-2042
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA83992208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI14199Medicare UPIN
CA00A839920Medicare ID - Type Unspecified