Rodriguez, Fausto Jose
Rodriguez, Fausto Jose is an individual health care provider with primary practice located at 10833 Le Conte Ave Rm 18170B , Los Angeles CA 90095-0010. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Rodriguez, Fausto Jose can be contacted via phone (310) 206-5008.Contact Information
Primary practice address
10833 Le Conte Ave Rm 18170B
Los Angeles CA 90095-0010
Phone: (310) 206-5008
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | D71393 | Maryland |
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | C173820 | Maryland |
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 46086 | Minnesota |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | C173820 | Maryland |
Profile Details
| NPI number | 1912979204 |
|---|---|
| LBN Legal business name | Rodriguez, Fausto Jose |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Nov 29th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912979204 | NPPES |
| Minnesota | MEDICAID | 540628500 | |
| Minnesota | MEDICAID | 038455100 |
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