Individual
IVAN W ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 814-2540
(626) 814-2540
Mailing address
PO BOX 635, WEST COVINA, CA 91793-0635
(626) 813-9988
(626) 813-0049
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
C24928
CA
2085N0700X
Neuroradiology Physician
C24928
CA
2085N0904X
Nuclear Radiology Physician
C24928
CA
2085P0229X
Pediatric Radiology Physician
C24928
CA
2085R0202X
Diagnostic Radiology Physician
Primary
C24928
CA
2085R0203X
Therapeutic Radiology Physician
C24928
CA
2085R0204X
Vascular & Interventional Radiology Physician
C24928
CA
2085U0001X
Diagnostic Ultrasound Physician
C24928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C249280
BSBC
CA
05
—
00C249280
—
CA
Enumeration date
07/25/2006
Last updated
07/03/2008
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