Individual
DR. HEIDELENE E DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16125 KAMANA RD, APPLE VALLEY, CA 92307-1377
(760) 946-2600
(760) 946-5600
Mailing address
16125 KAMANA RD, APPLE VALLEY, CA 92307-1377
(760) 946-2600
(760) 946-5600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036099009
IL
208000000X
Pediatrics Physician
Primary
C52214
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360990099
—
IL
05
—
1154378693
—
IL
Enumeration date
05/30/2006
Last updated
05/04/2022
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