Individual
DR. MICHAEL R ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 N BROADWAY, LOS ANGELES, CA 90031-2219
(323) 221-6121
(323) 221-6120
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 269-5371
(626) 574-7188
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G33914
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0014310
—
CA
Enumeration date
09/26/2006
Last updated
01/16/2014
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