Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 007001 | NY |
Y | 213EP1101X | Primary Podiatric Medicine | E-5730 | CA |
N | 2081S0010X | Sports Medicine | E-5730 | CA |
N | 213ES0000X | Sports Medicine | E-5730 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E-5730 | CA |
NPI | 1447650718 |
---|---|
Provider Name | Dr. Alicia Rozario |
First Address | Hayward, CA 94543-0495 |
Second Address | San Dimas, CA 91773-2543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2014 |
Last Update Date | 16/11/2021 |