Individual
BOBBY G. ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1955 LONG BEACH BLVD STE 200, LONG BEACH, CA 90806-5501
(562) 437-6717
Mailing address
241 LOMA AVE, LONG BEACH, CA 90803-6077
(562) 882-4668
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
345573
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95004731
CA
Other
Enumeration date
02/09/2015
Last updated
03/30/2021
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