# GUSTAVO A. ROSALES, MD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rosales Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538332234
- **Authorized official:** DR. GUSTAVO A ROSALES MD (OWNER)
- **Authorized official phone:** (916) 428-0656

## Contact information

- **Practice address:** 7275 E SOUTHGATE DR, SUITE 102, SACRAMENTO, CA 95823-2628
- **Practice address phone:** (916) 428-0656
- **Practice address fax:** (916) 428-3763
- **Mailing address:** 5385 FRANKLIN BLVD STE K, SACRAMENTO, CA 95820-4717
- **Mailing address phone:** (916) 428-0656
- **Mailing address fax:** (916) 428-3763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A414750 | CA | Yes |

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 03/31/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A414750 | — | CA |