Provider Demographics
NPI:1649552472
Name:RODRIGUEZ, ANGELA MARIA
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 CONDOR DR
Mailing Address - Street 2:UNIT # 60
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2904
Mailing Address - Country:US
Mailing Address - Phone:310-634-2561
Mailing Address - Fax:
Practice Address - Street 1:2175 CONDOR DR
Practice Address - Street 2:UNIT # 60
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2904
Practice Address - Country:US
Practice Address - Phone:310-634-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider