Provider Demographics
NPI:1053097568
Name:AGUILAR-TANPHANICH, ROSARIO MARIA (NP)
Entity type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:MARIA
Last Name:AGUILAR-TANPHANICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 LA GOLONDRINA AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2706
Mailing Address - Country:US
Mailing Address - Phone:626-476-8462
Mailing Address - Fax:
Practice Address - Street 1:1701 LA GOLONDRINA AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2706
Practice Address - Country:US
Practice Address - Phone:626-476-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022801363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health