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Individual

CHRISTOPHER M ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
181 S BUENA VISTA ST, BURBANK, CA 91505-4504
(818) 847-3440
(818) 847-3499
Mailing address
PO BOX 513969, LOS ANGELES, CA 90051-3969
(310) 335-4065
(310) 335-4098

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G49966
CA
2085R0001X
Radiation Oncology Physician
Primary
C43111
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G499660
CA
01
300080912
RR MEDICARE
CA
05
59186232
CO
01
920006960
RR MEDICARE
CA
01
920007065
RR MEDICARE - CO
CO
Enumeration date
07/08/2005
Last updated
06/01/2015
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