Basic Information
| Provider Information | |||||||||
| NPI: | 1558468207 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FAUCETT | ||||||||
| FirstName: | RODNEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 HOWE AVE STE 335 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958251206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9165698484 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1276 HALYARD DR | ||||||||
| Address2: | |||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956913412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308655544 | ||||||||
| FaxNumber: | 5308659209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2006 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 20A5369 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207R00000X | 20A5369 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00AX53690 | 05 | CA | MEDICAID | 110065910 | 01 | CA | RAILROAD MEDICARE | OTHER |