Provider Demographics
NPI:1710213210
Name:DARNE, ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:DARNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5848 E ADDERLEY DR
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3741
Mailing Address - Country:US
Mailing Address - Phone:714-797-1271
Mailing Address - Fax:
Practice Address - Street 1:11110 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-6203
Practice Address - Country:US
Practice Address - Phone:562-860-2451
Practice Address - Fax:562-467-5076
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20516363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical