Provider Demographics
NPI:1447383617
Name:ABELLAR, ROSE MARY (NP)
Entity Type:Individual
Prefix:
First Name:ROSE MARY
Middle Name:
Last Name:ABELLAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11101 LA REINA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4237
Mailing Address - Country:US
Mailing Address - Phone:562-622-9500
Mailing Address - Fax:562-622-9513
Practice Address - Street 1:11101 LA REINA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4237
Practice Address - Country:US
Practice Address - Phone:562-622-9500
Practice Address - Fax:562-622-9513
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11121363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner