1073313979 NPI number — H RODRIGUEZ MEDICAL NEPHROLOGY A PROFESSIONAL CORPORATION

Table of content: (NPI 1073313979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073313979 NPI number — H RODRIGUEZ MEDICAL NEPHROLOGY A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H RODRIGUEZ MEDICAL NEPHROLOGY A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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NPI Number Information

NPI Number:
1073313979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 S BEVERLY DRIVE
Provider Second Line Business Mailing Address:
SUITE 425
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90035-1192
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-274-7300
Provider Business Mailing Address Fax Number:
310-274-7301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1125 S BEVERLY DRIVE
Provider Second Line Business Practice Location Address:
SUITE 425
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90035-1192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-274-7300
Provider Business Practice Location Address Fax Number:
310-274-7301
Provider Enumeration Date:
03/18/2025

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
310-274-7300

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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