Basic Information
Provider Information
NPI: 1104868124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRACHAN
FirstName: RODNEY
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4347 PORTAGE ST NW
Address2: STE 102
City: NORTH CANTON
State: OH
PostalCode: 447207371
CountryCode: US
TelephoneNumber: 7149732650
FaxNumber: 7149732655
Practice Location
Address1: 725 W LA VETA AVE
Address2: SUITE 270
City: ORANGE
State: CA
PostalCode: 92868
CountryCode: US
TelephoneNumber: 7147440900
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/12/2006
LastUpdateDate: 06/26/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG48297CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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