Provider Demographics
NPI:1992742738
Name:RODRIGUEZ, ELVIA DEL CARMEN (MD)
Entity type:Individual
Prefix:DR
First Name:ELVIA
Middle Name:DEL CARMEN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14609 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1723
Mailing Address - Country:US
Mailing Address - Phone:562-789-9592
Mailing Address - Fax:562-789-6102
Practice Address - Street 1:14609 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1723
Practice Address - Country:US
Practice Address - Phone:562-789-9592
Practice Address - Fax:562-789-6102
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG79728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG78854Medicare UPIN