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NPI Code Detail

MEDICARE: MR. MICHAEL BRENDAN ROSE MD

MEDICARE:  MR. MICHAEL BRENDAN 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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianC204833CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861758435
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL BRENDAN ROSE MD
Provider Business Mailing Address
First Line : 11234 ANDERSON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92350-1716
Country : US
Telephone Number : 877-558-6248
Fax Number :
Provider Business Practice Location Address
First Line : 11234 ANDERSON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92350-1716
Country : US
Telephone Number : 877-558-6248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2012
Last Update Date : 01/12/2026

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Directions to “ MR. MICHAEL BRENDAN ROSE MD” Practice Location

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