Individual
CORNELIUS ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1926 BEVERLY BLVD, LOS ANGELES, CA 90057-2402
(213) 607-2010
Mailing address
351 S ST ANDREWS PL, LOS ANGELES, CA 90020-4370
(213) 607-2010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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