Provider Demographics
NPI:1538165196
Name:SAENZ, RODOLFO E (MD)
Entity type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:E
Last Name:SAENZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 BROCKTON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0104
Mailing Address - Country:US
Mailing Address - Phone:951-585-1800
Mailing Address - Fax:951-585-1801
Practice Address - Street 1:4646 BROCKTON AVE STE 201
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0104
Practice Address - Country:US
Practice Address - Phone:951-585-1800
Practice Address - Fax:951-585-1801
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074074174400000X
CAA055646207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2069390Medicaid
OHSA0860582Medicare ID - Type Unspecified
OH2069390Medicaid