Provider Demographics
NPI:1891062998
Name:REY, RODOLFO (MD)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:REY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9939 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3528
Mailing Address - Country:US
Mailing Address - Phone:951-354-3216
Mailing Address - Fax:951-848-9968
Practice Address - Street 1:9939 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3528
Practice Address - Country:US
Practice Address - Phone:951-354-2229
Practice Address - Fax:951-687-1154
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT 200595207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology