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Physician Compare National (NPI:1760762587)

HEALTHCARE PROVIDER: KEVIN ROSE D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1760762587
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9032374806
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20120628000275
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name ROSE
Individual professional last name
Provider First Name KEVIN
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name PALMER COLLEGE CHIROPRACTIC - WEST SUNNYVALE
Individual professional's medical school
Graduation Year 2011
Individual professional's medical school graduation year
Primary Specialty CHIROPRACTIC
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2635 CAMINO DEL RIO S
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 200
Group Practice or individual's line 2 address
City SAN DIEGO
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 921083728
Group Practice or individual's zip code (9 digits when available)
Phone Number 6198184306
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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