Provider Demographics
NPI:1396706107
Name:RODRIGUEZ, NORBERTO A (MD)
Entity type:Individual
Prefix:
First Name:NORBERTO
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 E PASEO CIMARRON
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1113
Mailing Address - Country:US
Mailing Address - Phone:412-760-5444
Mailing Address - Fax:
Practice Address - Street 1:820 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0928
Practice Address - Country:US
Practice Address - Phone:412-422-4633
Practice Address - Fax:412-343-5229
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031330L2084P0800X
CAC1675122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000556362Medicaid
PA158649OtherHIGHMARK BCBS
PA158649OtherHIGHMARK BCBS
PA158649Medicare ID - Type UnspecifiedHGS ADMINISTRATORS