Basic Information
| Provider Information | |||||||||
| NPI: | 1639174501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COVARRUBIAS | ||||||||
| FirstName: | RODRIGO | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4030 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928344030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149924444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 26921 CROWN VALLEY PKWY | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926916501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149924444 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 04/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A38682 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.