Provider Demographics
NPI:1427378173
Name:JASON R ROSANO D C INC
Entity Type:Organization
Organization Name:JASON R ROSANO D C INC
Other - Org Name:PREMIER HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ROSANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-789-8661
Mailing Address - Street 1:PO BOX 9309
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90608-9309
Mailing Address - Country:US
Mailing Address - Phone:562-789-8661
Mailing Address - Fax:
Practice Address - Street 1:7624 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2300
Practice Address - Country:US
Practice Address - Phone:562-789-8661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27852111N00000X
111N00000X, 111NP0017X, 111NR0400X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27852Medicare PIN
CAU91243Medicare UPIN