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General NPI Number Information
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NPI Number | 1811175599
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Entity Type | Organization
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Legal Business Name | MARY KATE ROHAN M.D., INC
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 1211 W LA PALMA AVE STE 407
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City | ANAHEIM
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State | CA
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Zip | 92801-2806
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Country | US
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Telephone | 714-284-4912
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 W LA PALMA AVE STE 407
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City | ANAHEIM
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State | CA
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Zip | 92801-2806
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Country | US
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Telephone | 714-284-4912
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARY KATE ROHAN
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Credential | M.D.
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Telephone | 714-284-4912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G73700
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License Number State | CA
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