Healthcare Provider Details

I. General information

NPI: 1942331509
Provider Name (Legal Business Name): DEBBIE ANN IMPERIAL ROSARIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9990 COUNTY FARM RD
RIVERSIDE CA
92503-3542
US

IV. Provider business mailing address

737 JAMESTOWN RD
BURBANK CA
91504-2355
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4447
  • Fax:
Mailing address:
  • Phone: 818-559-8658
  • Fax: 818-559-8658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA84530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: