Provider Demographics
NPI:1821021981
Name:ROY, ROSALINDA AMOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALINDA
Middle Name:AMOR
Last Name:ROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8345 RESEDA BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4621
Mailing Address - Country:US
Mailing Address - Phone:818-775-5993
Mailing Address - Fax:818-993-9344
Practice Address - Street 1:21001 SHERMAN WAY
Practice Address - Street 2:SUITE 15
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1760
Practice Address - Country:US
Practice Address - Phone:818-716-0048
Practice Address - Fax:818-348-4904
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC42697208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C426970Medicaid
CA00A522370Medicaid
CA00A882980Medicaid
CA954326237OtherTAX ID
CAGR0076970Medicaid
CAGR0076971Medicaid
CA954326237OtherTAX ID
CA00A882980Medicaid