Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | A88668 | CA |
NPI | 1285720292 |
---|---|
Provider Name | Tena La Dawn Rosser |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 24/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A886680 | (05) | CA |
00A886680 L59 | CAL OPTIMA (01) | CA |
H60930 | (02) | |
H60930 | (02) | CA |