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Organization
SANTA ROSA FAMILY CARE CENTER
Active
Organization
SANTA ROSA FAMILY CARE CENTER
Active
Parent organization
SANTA ROSA FAMILY CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANTA ROSA FAMILY CARE CENTER
Authorized official
MRS. TERESA S ORTIZ FNP (PRESIDENT)
(323) 583-6814
Entity
Organization
Contact information
Practice address
1234 E FLORENCE AVE, SUITE B, LOS ANGELES, CA 90001-2433
(323) 583-6814
(323) 583-6818
Mailing address
1234 E FLORENCE AVE, LOS ANGELES, CA 90001-2433
(323) 583-6814
(323) 583-6818
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GNP000151
—
CA
Enumeration date
01/28/2008
Last updated
08/25/2008
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