Individual
DOUGLAS RYAN ROSENTRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
9909 MIRA MESA BLVD, STE 120, SAN DIEGO, CA 92131-1056
(858) 693-0436
(858) 693-0437
Mailing address
540 S ANDREASEN DR STE C, ESCONDIDO, CA 92029-1916
(760) 591-7750
(760) 294-9813
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3630
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
CA
Enumeration date
07/26/2011
Last updated
07/26/2011
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