Basic Information
| Provider Information | |||||||||
| NPI: | 1669113387 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | ALEXA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15842 S HASKINS AVE | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902203235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108921314 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14300 ORCHARD PKWY FL 1 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034305560 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2022 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | TL.0009221 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | TL.0009221 | CO | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.