Provider Demographics
NPI:1366256059
Name:RODRIGUES, DRAYTON
Entity type:Individual
Prefix:
First Name:DRAYTON
Middle Name:
Last Name:RODRIGUES
Suffix:
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 1:11570 CAMINITO LA BAR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6013
Mailing Address - Country:US
Mailing Address - Phone:801-703-8938
Mailing Address - Fax:
Practice Address - Street 1:11570 CAMINITO LA BAR UNIT 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6013
Practice Address - Country:US
Practice Address - Phone:801-703-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information