Most Relevant Information
Provider Data
| NPI Number: | 1003048588 |
| Provider Name: | ROXANA GILDA DE LA ROSA O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 13835 |
Most Important Dates
| Enumeration Date: | 08/17/2009 |
| Last Updated: | 04/02/2013 |
Provider Practice Location
105 1/2 S VERMONT AVE
LOS ANGELES
CA
900045904
Practice Location Phone/Fax
| Phone: | 2133838036 |
| Fax: |
Provider Mailing Location
1652 S BERENDO ST
LOS ANGELES
CA
900064411
Provider Mailing Phone/Fax
| Phone: | 3237345307 |
| Fax: |