Provider Demographics
NPI:1205937349
Name:DEL ROSARIO, MARITES P (MD)
Entity type:Individual
Prefix:DR
First Name:MARITES
Middle Name:P
Last Name:DEL ROSARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6530
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-6530
Mailing Address - Country:US
Mailing Address - Phone:661-726-2826
Mailing Address - Fax:661-948-0432
Practice Address - Street 1:1672 W AVENUE J
Practice Address - Street 2:STE 110
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-726-2826
Practice Address - Fax:661-723-9557
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53570174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist