Provider Demographics
NPI:1528010964
Name:FRANCO, ROSINA (MD)
Entity Type:Individual
Prefix:
First Name:ROSINA
Middle Name:
Last Name:FRANCO
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:PO BOX 70304
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91117-7304
Mailing Address - Country:US
Mailing Address - Phone:213-202-7584
Mailing Address - Fax:213-580-6559
Practice Address - Street 1:1430 SAN JULIAN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3142
Practice Address - Country:US
Practice Address - Phone:213-202-7584
Practice Address - Fax:213-580-6559
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00277835OtherMEDICARE RAILROAD
CA00A547930Medicaid
CA00A547930OtherBLUE SHIELD
CAG57001Medicare UPIN
GAP00277835OtherMEDICARE RAILROAD
CAWA54793AMedicare PIN