Provider Demographics
NPI:1811949449
Name:ROSADO-COSME, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:ROSADO-COSME
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:6303 OWENSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2264
Mailing Address - Country:US
Mailing Address - Phone:818-936-3554
Mailing Address - Fax:818-936-2101
Practice Address - Street 1:26877 TOURNEY RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1846
Practice Address - Country:US
Practice Address - Phone:661-290-7040
Practice Address - Fax:661-222-2013
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA-75995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A759950Medicaid
CA00A759950Medicaid
CA00A759950Medicare PIN