Michellin De La Rosa, | |
14457 Roscoe Blvd, Panorama City, CA 91402-3012 | |
(818) 810-5947 | |
Not Available |
Full Name | Michellin De La Rosa |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 14457 Roscoe Blvd, Panorama City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962967778 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | NP95010751 (California) | Primary |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Mailing Address | Practice Location Address |
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Michellin De La Rosa, 655 S Hope St Unit 903, Los Angeles, CA 90017-3220 Ph: (909) 618-7067 | Michellin De La Rosa, 14457 Roscoe Blvd, Panorama City, CA 91402-3012 Ph: (818) 810-5947 |
Gloria S Tongson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Tina J Woolfork, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Ms. Tenika Nettles, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9618 Van Nuys Blvd Apt 106, Panorama City, CA 91402 Phone: 323-684-4577 | |
Mary Bernadette Acuna Coburn, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Hilda Berenice Jacobo, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8727 Van Nuys Blvd, Panorama City, CA 91402 Phone: 818-899-5555 | |
Sharon M Poncher, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 | |
Velda C Mowry, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 |