Individual
DONALD ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 ROSS AVE, EL CENTRO, CA 92243-4306
(760) 339-7100
(760) 339-7389
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A35508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A355081
—
CA
01
—
A35508
MEDICAL LICENSE
CA
Enumeration date
06/22/2006
Last updated
08/23/2019
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