Basic Information
| Provider Information | |||||||||
| NPI: | 1427653435 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | YAMILI | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHARM D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76713 NEW YORK AVE | ||||||||
| Address2: | |||||||||
| City: | PALM DESERT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922110947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654308190 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 900 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BRAWLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922272630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603446471 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2020 | ||||||||
| LastUpdateDate: | 11/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 333600000X | 78122 | CA | Y | Suppliers | Pharmacy |
No ID Information.