Provider Demographics
NPI:1609806827
Name:ROS, EMY PAZ R
Entity Type:Individual
Prefix:
First Name:EMY
Middle Name:PAZ R
Last Name:ROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SAN PABLO ST
Mailing Address - Street 2:SUITE 1652
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-5310
Mailing Address - Country:US
Mailing Address - Phone:323-442-6000
Mailing Address - Fax:323-442-6001
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1652
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-6000
Practice Address - Fax:323-442-6001
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA418632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry