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Individual

MR. DERRICK ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
11234 ANDERSON ST, 2532, LOMA LINDA, CA 92354-2804
(909) 558-1000
Mailing address
11234 ANDERSON ST, 2532, LOMA LINDA, CA 92354-2804
(909) 558-1000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3787
CA

Other

Enumeration date
05/22/2009
Last updated
05/22/2009
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