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

Roderick Lazo, PA

Individual provider Physician Assistant · NPI 1588789754

Roderick Lazo, PA is a Physician Assistant in San Marcos, California. Qualified in 2000, 26 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
26
Licensed in
CA
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

400 Craven Rd
San Marcos, CA 92078-4201
Phone: (760) 736-4125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4647 Zion Ave, San Diego, CA 92120-2507 — (619) 528-5000
  • 3030 Childrens Way, San Diego, CA 92123-4232 — (858) 966-6789

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA15633 (CA)

Record details

NPI number1588789754
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 20, 2007
Last updated in NPPESDecember 1, 2021
Certification dateNovember 24, 2021
Mailing address400 Craven Rd, San Marcos, CA 92078-4201

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in San Marcos