MEDICARE: APOLIS INDUSTRIAL MULTISPECIALTY 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	174400000X	Specialist

General Provider Information

NPI Number	:	1760838312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLIS INDUSTRIAL MULTISPECIALTY INC.

Provider Business Mailing Address
First Line	:	1950 E 17TH ST
Second Line	:	SUITE 215
City	:	SANTA ANA
State	:	CA
Zip	:	92705-6852
Country	:	US
Telephone Number	:	714-495-4050
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 E 17TH ST
Second Line	:	SUITE 215
City	:	SANTA ANA
State	:	CA
Zip	:	92705-6852
Country	:	US
Telephone Number	:	714-495-4050
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MANUEL G ROSARIO
Credential	:	D.O
Telephone Number	:	714-495-4050

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	05/12/2016

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