Individual ProviderThomas RodriguezPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1200 N State St, Los Angeles, CA 90033-1029(323) 226-5555(949) 432-7815PECOS EnrollmentBased on the most recent information from CMS, provider Thomas Rodriguez is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124446224Provider TypeIndividualFull NameRodriguez, ThomasCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/4/2014Last Updated5/13/2020Contact InformationPractice LocationPractice Address1200 N State St, Los Angeles, CA 90033-1029Phone(323) 226-5555FaxUnlisted FaxMailing LocationMailing Address1146 N Central Ave # 108, Glendale, CA 91202-2506Phone(949) 432-7815FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA135485CaliforniaCode2084F0202XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA135485California