Provider Information for 1962541698
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MAURICIO O RODRIGUEZ
Sex: Male
NPI: 1962541698
Last Updated: 2014-10-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1962541698 | ||||||||||||
| Enumeration Date | 2007-02-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 439 26TH AVE APT. 1 SAN FRANCISCO, CA 94121-1987 United States Phone: 415-533-2218 | Fax: | ||||||||||||
| Primary Practice Address | 439 26TH AVE APT. 1 SAN FRANCISCO, CA 94121-1987 United States Phone: 415-533-2218 | Fax: | ||||||||||||
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