Healthcare Provider Details

I. General information

NPI: 1114019015
Provider Name (Legal Business Name): ROSE AVENUE FAMILY MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 W GONZALES RD STE 230
OXNARD CA
93036
US

IV. Provider business mailing address

451 W GONZALES RD STE 230
OXNARD CA
93036-0726
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-1443
  • Fax: 805-988-0897
Mailing address:
  • Phone: 805-988-1443
  • Fax: 805-988-0897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPHINE SOLIZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-988-1443