Provider Demographics
NPI:1982169868
Name:ARANGO, RODOLFO RAFAEL JR
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:RAFAEL
Last Name:ARANGO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 NUGGET AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE ISABELLA
Mailing Address - State:CA
Mailing Address - Zip Code:93240-9456
Mailing Address - Country:US
Mailing Address - Phone:760-379-3412
Mailing Address - Fax:
Practice Address - Street 1:2731 NUGGET AVE
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240-9456
Practice Address - Country:US
Practice Address - Phone:760-379-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator