Leo Steven Rodriguez, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Bma San Nicolas Is
Naval Outlying Landing Field
Point Mugu Nawc, CA 93042-0001

Phone

(805) 989-8030

NPI assigned

Aug 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1811189293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28525 PLANTAIN ST",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847495",
            "telephone_number": "951-269-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BMA SAN NICOLAS IS",
            "address_2": "NAVAL OUTLYING LANDING FIELD",
            "city": "POINT MUGU NAWC",
            "state": "CA",
            "postal_code": "930420001",
            "telephone_number": "805-989-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LEO",
        "middle_name": "STEVEN",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2012-02-23",
        "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": []
}

• Mark Palcan, PSYD
• Paul McLain Ziemer, IDC

• All providers in Point Mugu Nawc, CA
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.