MEDICARE: ROS MEDICAL GROUP 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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1417463563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROS MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	409 W MAIN ST
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-3433
Country	:	US
Telephone Number	:	626-382-1263
Fax Number	:	626-382-1252

Provider Business Practice Location Address
First Line	:	1730 S SAN GABRIEL BLVD STE B
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3928
Country	:	US
Telephone Number	:	626-573-1252
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SINGH AHN BOUN
Credential	:	MD
Telephone Number	:	626-382-1263

Provider Enumeration Date	:	12/26/2017
Last Update Date	:	12/26/2017

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Directions to “ROS MEDICAL GROUP INC ” Practice Location

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