Most Relevant Information
Provider Data
| NPI Number: | 1003043761 |
| Provider Name: | EDWARD SEAN RODRIGUEZ I.D.M.T |
| Entity Type: | Individual |
| Taxonomy Code: | 1710I1003X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/19/2009 |
| Last Updated: | 06/19/2009 |
Provider Practice Location
101 BODIN CIR
TRAVIS AFB
CA
945351809
Practice Location Phone/Fax
| Phone: | 7074235478 |
| Fax: |
Provider Mailing Location
5029 ROWE DR
FAIRFIELD
CA
945336591
Provider Mailing Phone/Fax
| Phone: | 7076315512 |
| Fax: |