Active NPI
Guillermo Rodriguez Jr., D.C.
- Chiropractor
- Moreno Valley, CA
National Provider Identifier
1891869657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC-29988
- Practice address
- 12981 Perris Blvd
Suite 106
Moreno Valley, CA 92553-4102 - Phone
- (951) 485-6300
- Fax
- (951) 485-6322
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-29988 | CA | Primary |
Addresses
Primary practice location
12981 Perris Blvd
Suite 106
Moreno Valley, CA 92553-4102
Mailing address
15550 Rockfield Blvd
B220
Irvine, CA 92618-2720
Phone (949) 598-9999
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC29988 | Other | CA | CHIROPRACTIC LICENSE |
| DA128Z | Other | CA | INDIVIDUAL PTAN |
| 1326291931 | Other | CA | GROUP NPI |
| DA127A | Other | CA | GROUP PTAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29988 | CA | MD | Mental Health Counselor |
| DC-29988 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520899200000",
"number": "1891869657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15550 ROCKFIELD BLVD",
"address_2": "B220",
"city": "IRVINE",
"state": "CA",
"postal_code": "926182720",
"telephone_number": "949-598-9999",
"fax_number": "949-598-9990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12981 PERRIS BLVD",
"address_2": "SUITE 106",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925534102",
"telephone_number": "951-485-6300",
"fax_number": "951-485-6322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "GUILLERMO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2018-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC-29988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTIC LICENSE",
"identifier": "DC29988",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL PTAN",
"identifier": "DA128Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1326291931",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "DA127A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.