Provider Demographics
NPI:1194889402
Name:ROSE, FRANK JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:ROSE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:24672 SAN JUAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2845
Mailing Address - Country:US
Mailing Address - Phone:949-499-1371
Mailing Address - Fax:949-499-2521
Practice Address - Street 1:24672 SAN JUAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2845
Practice Address - Country:US
Practice Address - Phone:949-499-1371
Practice Address - Fax:949-499-2521
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2015-09-02
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Provider Licenses
StateLicense IDTaxonomies
CA-A22514207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23113Medicare UPIN