Individual
DEREK J ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3745 OVERLAND AVE, LOS ANGELES, CA 90034-6311
(310) 392-5855
Mailing address
3745 OVERLAND AVE, LOS ANGELES, CA 90034-6311
(310) 392-5855
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
03/05/2025
Last updated
05/16/2025
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