Provider Demographics
NPI:1225377880
Name:ROSAS, ROBERTO CASTANEDA (DC)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:CASTANEDA
Last Name:ROSAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19171 MAGNOLIA ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-2244
Mailing Address - Country:US
Mailing Address - Phone:714-454-6227
Mailing Address - Fax:714-962-6432
Practice Address - Street 1:19171 MAGNOLIA ST
Practice Address - Street 2:SUITE #2
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-2244
Practice Address - Country:US
Practice Address - Phone:714-454-6227
Practice Address - Fax:714-962-6432
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor