Provider Demographics
NPI:1265451801
Name:ESPINOSA, ROSALIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:E
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 WHIRLAWAY LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2583
Mailing Address - Country:US
Mailing Address - Phone:951-640-4500
Mailing Address - Fax:
Practice Address - Street 1:900 S MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3401
Practice Address - Country:US
Practice Address - Phone:951-734-5450
Practice Address - Fax:951-734-6009
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51359261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center