Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BLAKE FUNG RODMAN
ActiveBLAKE FUNG RODMAN is a Athletic Trainer healthcare provider located in SOUTH LAKE TAHOE, California. NPI 1588370555 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SOUTH LAKE TAHOE, CA
Registration Details
- NPI Number
- 1588370555
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 24, 2023 (3.5341763607401 yrs)
- Last Updated
- Jun 8, 2025
Practice Information
- Address
-
2170 SOUTH AVESOUTH LAKE TAHOE, CA, 961507026Browse CA providers · Browse ZIP 96150
- Phone
- 5305396600
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SOUTH LAKE TAHOE, CA
| Name | Credential | NPI |
|---|---|---|
| JAMES JONATHAN PRATT | MS, ATC, OTC | 1891943528 |
| ANDREW S BORAH | ATC | 1407248081 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.