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1568669992
RODERICK DEAN PONATH
TUSTIN, CA
NPI
1568669992
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA A25415)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
Dr. RODERICK DEAN PONATH M.D.
17291 IRVINE BLVD SUITE 104
TUSTIN, CA 92780-2941
Phone number: 415-990-2502
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Mailing Address
Dr. RODERICK DEAN PONATH M.D.
PO BOX 447
SAN QUENTIN, CA 94964-0447
Phone number: 415-990-2502
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