Provider Demographics
NPI:1881366599
Name:RODRIGUEZ, ALEJANDRO (PT)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 COMPASS POINT DR S UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-8525
Mailing Address - Country:US
Mailing Address - Phone:408-674-8002
Mailing Address - Fax:
Practice Address - Street 1:9520 COMPASS POINT DR S UNIT 5
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-8525
Practice Address - Country:US
Practice Address - Phone:408-674-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist