Provider Demographics
NPI:1770851099
Name:FRANCISCO RODRIGUEZ, D.O.
Entity Type:Organization
Organization Name:FRANCISCO RODRIGUEZ, D.O.
Other - Org Name:DREAMWEAVER MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:G
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-289-0400
Mailing Address - Street 1:330 W LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1213
Mailing Address - Country:US
Mailing Address - Phone:626-289-0040
Mailing Address - Fax:626-296-9505
Practice Address - Street 1:330 W LAS TUNAS DR
Practice Address - Street 2:SUITE#1
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1213
Practice Address - Country:US
Practice Address - Phone:626-289-0040
Practice Address - Fax:626-296-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10175261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578898250Medicaid