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NPI Code Detail

MEDICARE: ROSEMARIE QUIMSON-CRUZ, DMD, INC.

MEDICARE: ROSEMARIE QUIMSON-CRUZ, DMD, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist44478CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11223G0001XOTHERCAGENERAL DENTIST

General Provider Information

NPI Number : 1033513528
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSEMARIE QUIMSON-CRUZ, DMD, INC.
Provider Business Mailing Address
First Line : 2252 BEVERLY BLVD STE 102
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2246
Country : US
Telephone Number : 323-228-1250
Fax Number :
Provider Business Practice Location Address
First Line : 2252 BEVERLY BLVD STE 102
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-2246
Country : US
Telephone Number : 323-228-1250
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. ROSEMARIE R. QUIMSON-CRUZ
Credential : DMD
Telephone Number : 213-387-6453
Provider Enumeration Date : 10/13/2014
Last Update Date : 10/13/2014

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