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NPI Code Detail

MEDICARE: MR. ENRIQUE ROSALES JR.

MEDICARE: MR. ENRIQUE ROSALES JR.
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1275485492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ENRIQUE ROSALES JR.
Provider Business Mailing Address
First Line : 5203 BORLAND RD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90032-3915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 440 E HUNTINGTON DR STE 300
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3775
Country : US
Telephone Number : 626-531-6999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ MR. ENRIQUE ROSALES JR. ” Practice Location

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