Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Fung Rodman

Individual provider Athletic Trainer · NPI 1588370555

Blake Fung Rodman is an Athletic Trainer in South Lake Tahoe, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone: (530) 539-6600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1588370555
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 24, 2023
Last updated in NPPESJune 8, 2025
Certification dateJune 7, 2025

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