Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 18934 | CA |
NPI | 1033401492 |
---|---|
Provider Name | Ms. Karen Rosen |
First Address | Orange, CA 92865 |
Second Address | Orange, CA 92865-2505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2011 |
Last Update Date | 04/05/2011 |