Healthcare Provider Details

I. General information

NPI: 1871679613
Provider Name (Legal Business Name): ROSA M BRIBIESCA NP NURSE PRACTITIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSA M PULIDO

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 W LINCOLN AVE
ANAHEIM CA
92801-6730
US

IV. Provider business mailing address

1814 W LINCOLN AVE
ANAHEIM CA
92801-6730
US

V. Phone/Fax

Practice location:
  • Phone: 714-635-0593
  • Fax: 714-780-5696
Mailing address:
  • Phone: 714-635-0593
  • Fax: 714-780-5696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberRN500207
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: