Provider Demographics
NPI:1366751778
Name:SWITZER, RODERICK KIRK
Entity type:Individual
Prefix:MR
First Name:RODERICK
Middle Name:KIRK
Last Name:SWITZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 S NAUTICAL ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-4921
Mailing Address - Country:US
Mailing Address - Phone:714-206-8246
Mailing Address - Fax:714-750-1067
Practice Address - Street 1:2135 S NAUTICAL ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-4921
Practice Address - Country:US
Practice Address - Phone:714-206-8246
Practice Address - Fax:714-750-1067
Is Sole Proprietor?:No
Enumeration Date:2010-10-03
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS2010-01665172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver