Doctor Name: | ANTONIO HURTADO RODRIGUEZ |
NPI Number: | 1255587820 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 109646 |
Business Practice Address: | 363 S Park Ave Ste 104a Pomona, CA - 917661560 |
Business Phone Number: | 9096223700 |
Business Fax Number: | 9096223744 |
Mailing Address: | 363 S Park Ave Ste 104a, POMONA |
State: | CA |
Postal Code: | 917661560 |
Phone Number: | 9096223700 |
Fax Number: | 9096223744 |
NPI Enumeration Date: | 08/14/2008 |
NPI Last Update Date: | 02/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 109646 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |