Individual
DR. JONATHAN DOUGLAS ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
615 HAMPTON DR, UNIT A301, VENICE, CA 90291-2790
(310) 717-1494
Mailing address
615 HAMPTON DR, UNIT A301, VENICE, CA 90291-2790
(310) 717-1494
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
242646-1
NY
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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