| Dr Krista Michelle Rodriguez-bruno, MD | |
|
9834 Genesee Ave Ste 416, La Jolla, CA 92037-1264 | |
| (858) 458-1287 | |
| (858) 452-9160 |
| Full Name | Dr Krista Michelle Rodriguez-bruno |
|---|---|
| Gender | Female |
| Speciality | Otolaryngology |
| Location | 9834 Genesee Ave Ste 416, La Jolla, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073726444 | NPI | - | NPPES |
| 037375300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | D70424 (Maryland) | Secondary |
| 207Y00000X | Otolaryngology | A99037 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Krista Michelle Rodriguez-bruno, MD 9834 Genesee Ave Ste 416, La Jolla, CA 92037-1264 Ph: (858) 458-1287 | Dr Krista Michelle Rodriguez-bruno, MD 9834 Genesee Ave Ste 416, La Jolla, CA 92037-1264 Ph: (858) 458-1287 |
Dr. Peter Dixon, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 9300 Campus Point Dr, La Jolla, CA 92037 Phone: 858-657-8590 | |
Mahmood Mahdavi, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 9850 Genesee Ave, Ste 710, La Jolla, CA 92037 Phone: 858-458-9955 Fax: 858-452-7848 | |
Tammy Pham, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 9300 Campus Point Dr # 7895, La Jolla, CA 92037 Phone: 619-321-8776 | |
Dr. Keith Jay Wahl, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 8735 Nottingham Pl, La Jolla, CA 92037 Phone: 858-518-2190 Fax: 858-455-0655 | |
Dr. Brendan Gaylis, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 10666 N Torrey Pines Rd, La Jolla, CA 92037 Phone: 858-554-8959 Fax: 858-784-5933 | |
Carolyn A Montes, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 4150 Regents Park Row Ste 345, La Jolla, CA 92037 Phone: 858-926-7010 Fax: 858-926-7011 |