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Individual

DR. DAVID JOSEPH DEROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20601 WEST PAOLI LANE, WEIMAR, CA 95736-0486
(530) 637-4111
(530) 637-4443
Mailing address
PO BOX 486, WEIMAR, CA 95736-0486
(530) 637-4111
(530) 637-4443

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G83828
CA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
G83828
CA

Other

Enumeration date
02/02/2010
Last updated
02/02/2010
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