MEDICARE: ROZEKORIA, 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	122300000X	Dentist	48390	CA

General Provider Information

NPI Number	:	1760697445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROZEKORIA, INC.

Provider Business Mailing Address
First Line	:	5555 DEL AMO BLVD
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-2307
Country	:	US
Telephone Number	:	562-866-1735
Fax Number	:	562-866-8190

Provider Business Practice Location Address
First Line	:	180 NEWPORT CENTER DR
Second Line	:	#210
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6972
Country	:	US
Telephone Number	:	562-866-1735
Fax Number	:	562-866-8190

Authorized Official
Title or Position	:	OWNER
Name	:	ANITA TOMKORIA
Credential	:	DDS
Telephone Number	:	562-866-1735

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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Directions to “ROZEKORIA, INC. ” Practice Location

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