Provider Demographics
NPI:1669169306
Name:DEL ROSARIO, CHRISTIAN JACOB (ND)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JACOB
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ISLAND AVE APT 1800
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7963
Mailing Address - Country:US
Mailing Address - Phone:818-357-6770
Mailing Address - Fax:
Practice Address - Street 1:1412 CAMINO DEL MAR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2551
Practice Address - Country:US
Practice Address - Phone:858-461-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1417202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine