MEDICARE: MR. DANIEL M. ROSE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A44506	CA

General Provider Information

NPI Number	:	1285668962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL M. ROSE MD

Provider Business Mailing Address
First Line	:	14435 HAMLIN ST
Second Line	:	SUITE #104
City	:	VAN NUYS
State	:	CA
Zip	:	91401-6205
Country	:	US
Telephone Number	:	714-345-8427
Fax Number	:	818-855-1254

Provider Business Practice Location Address
First Line	:	14435 HAMLIN ST
Second Line	:	SUITE #104
City	:	VAN NUYS
State	:	CA
Zip	:	91401-6205
Country	:	US
Telephone Number	:	714-345-8427
Fax Number	:	818-855-1254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/03/2025

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