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General NPI Number Information
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NPI Number | 1275221103
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Entity Type | Individual
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Provider Name | MICHAEL DA ROSA MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 12401 WASHINGTON BLVD
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City | WHITTIER
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State | CA
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Zip | 90602-1006
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Country | US
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Telephone | 562-698-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 153 HARLANDALE AVE
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City | TORONTO
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State | ON
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Zip | M2N1P5
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 185838
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License Number State | CA
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