Provider Demographics
NPI:1073873733
Name:ROSARIO ROSARIO, GISELA (MD)
Entity Type:Individual
Prefix:MS
First Name:GISELA
Middle Name:
Last Name:ROSARIO ROSARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GISELA
Other - Middle Name:
Other - Last Name:ROSARIO ROSARIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 29159
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-0159
Mailing Address - Country:US
Mailing Address - Phone:818-550-1998
Mailing Address - Fax:818-660-1364
Practice Address - Street 1:8635 W 3RD ST STE 465W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6111
Practice Address - Country:US
Practice Address - Phone:310-358-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201338207R00000X
CAA136895207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine