Provider Demographics
NPI:1265781538
Name:ROSE, TARYN (MD)
Entity type:Individual
Prefix:DR
First Name:TARYN
Middle Name:
Last Name:ROSE
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 1:215 S BEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3722
Mailing Address - Country:US
Mailing Address - Phone:213-820-9009
Mailing Address - Fax:253-559-1922
Practice Address - Street 1:215 S BEDFORD DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3722
Practice Address - Country:US
Practice Address - Phone:213-820-9009
Practice Address - Fax:253-559-1922
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79373207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery