Provider Demographics
NPI:1215119821
Name:ROSALES, CRISTINA MARIE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:MARIE
Last Name:ROSALES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:5823 YORK BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2634
Mailing Address - Country:US
Mailing Address - Phone:323-255-5643
Mailing Address - Fax:323-254-2158
Practice Address - Street 1:815 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-6123
Practice Address - Country:US
Practice Address - Phone:323-728-3955
Practice Address - Fax:323-728-6905
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2018-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA19519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant