Kathy Heaven Rosales Pou, | |
3690 Virginia Rd, Los Angeles, CA 90016-5855 | |
(323) 496-9724 | |
Not Available |
Full Name | Kathy Heaven Rosales Pou |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3690 Virginia Rd, Los Angeles, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427819754 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 1073578 (Texas) | Primary |
Entity Name | Rio Grande Anesthesia & Pain Medicine Consultants, P .a. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962457234 PECOS PAC ID: 4880507763 Enrollment ID: O20031106000738 |
Mailing Address | Practice Location Address |
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Kathy Heaven Rosales Pou, 3690 Virginia Rd, Los Angeles, CA 90016-5855 Ph: (323) 496-9724 | Kathy Heaven Rosales Pou, 3690 Virginia Rd, Los Angeles, CA 90016-5855 Ph: (323) 496-9724 |
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