Individual provider Active NPI

Rodolfo Guerrero, INDEPENDENT DUTY COR

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1124253208
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
2051 Cushing Rd
San Diego, CA 92106-6173
Phone
(619) 524-0113
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

2051 Cushing Rd
San Diego, CA 92106-6173

Mailing address

512 N 32ND LN
McAllen, TX 78501-8078
Phone (760) 429-8035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1124253208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N 32ND LN",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785018078",
            "telephone_number": "760-429-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CUSHING RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066173",
            "telephone_number": "619-524-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "RODOLFO",
        "name_prefix": "Mr.",
        "credential": "INDEPENDENT DUTY COR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.