Provider Demographics
NPI:1609285618
Name:LEON, ROSEMARY CARRASCO (MD, PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:CARRASCO
Last Name:LEON
Suffix:
Gender:F
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32665 RAY CT STREET
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-9347
Mailing Address - Country:US
Mailing Address - Phone:559-901-9304
Mailing Address - Fax:559-733-2636
Practice Address - Street 1:32665 RAY COURT STREET
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292
Practice Address - Country:US
Practice Address - Phone:559-901-9304
Practice Address - Fax:559-733-2636
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44854207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology