Organization
CLINICA MSR OSCAR A ROMERO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ROSSATO (EXECUTIVE DIRECTOR)
(213) 201-2737
Entity
Organization
Contact information
Practice address
201 S ALVARADO ST STE 100, LOS ANGELES, CA 90057-2356
(323) 987-1030
Mailing address
123 S ALVARADO ST, LOS ANGELES, CA 90057-2201
(213) 201-2737
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
550001341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70567F
—
CA
Enumeration date
07/24/2014
Last updated
07/31/2014
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