Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G36060 | CA |
NPI | 1871660704 |
---|---|
Provider Name | Rosetta Loree Willis Hassan |
First Address | Bellflower, CA 90706-2246 |
Second Address | Bellflower, CA 90706-2246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 20/03/2019 |