Provider Demographics
NPI:1861686487
Name:OSUNA, ROSE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:OSUNA
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 1:1640 MARENGO ST
Mailing Address - Street 2:HRA BUILDING 3RD FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1036
Mailing Address - Country:US
Mailing Address - Phone:323-226-2200
Mailing Address - Fax:
Practice Address - Street 1:1640 MARENGO ST
Practice Address - Street 2:HRA BUILDING 3RD FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1036
Practice Address - Country:US
Practice Address - Phone:323-226-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252343363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology