Healthcare Provider Details

I. General information

NPI: 1053566893
Provider Name (Legal Business Name): JASON R ROSANO D C INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7624 PAINTER AVE STE 200
WHITTIER CA
90602-2328
US

IV. Provider business mailing address

PO BOX 9309
WHITTIER CA
90608-9309
US

V. Phone/Fax

Practice location:
  • Phone: 562-789-8661
  • Fax:
Mailing address:
  • Phone: 562-789-8661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27852
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON ROBERT ROSANO
Title or Position: CEO
Credential: DC
Phone: 562-822-0460