| Mark J Rodrigues Md Inc | |
|
1140 W La Veta Ave Ste 470 Orange CA 92868-4200 | |
| (714) 245-9933 | |
| (714) 245-9923 |
| Full Name | Mark J Rodrigues Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1140 W La Veta Ave Ste 470, Orange, California |
| Authorized Official Name and Position | Mark J Rodrigues (PRESIDENT) |
| Authorized Official Contact | 7142459933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark J Rodrigues Md Inc 1140 W La Veta Ave Ste 470 Orange CA 92868-4200 Ph: (714) 245-9933 | Mark J Rodrigues Md Inc 1140 W La Veta Ave Ste 470 Orange CA 92868-4200 Ph: (714) 245-9933 |
| NPI Number | 1598909418 |
|---|---|
| Provider Enumeration Date | 04/22/2009 |
| Last Update Date | 04/27/2009 |
| Medicare PECOS PAC ID | 9537214473 |
|---|---|
| Medicare Enrollment ID | O20090828000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598909418 | NPI | - | NPPES |
| 00A463400 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A46340 (California) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | A46340 (California) | Secondary |
| Provider Name | Mark Jervis Rodrigues |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417977992 PECOS PAC ID: 1557428281 Enrollment ID: I20090325000648 |
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