Provider Demographics
NPI:1053339960
Name:ROSAS, MARILOU C (MD)
Entity type:Individual
Prefix:
First Name:MARILOU
Middle Name:C
Last Name:ROSAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:32605 TEMECULA PKWY
Mailing Address - Street 2:SUITE 219
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6837
Mailing Address - Country:US
Mailing Address - Phone:951-506-9112
Mailing Address - Fax:951-506-9113
Practice Address - Street 1:32605 TEMECULA PKWY
Practice Address - Street 2:SUITE 219
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6837
Practice Address - Country:US
Practice Address - Phone:951-506-9112
Practice Address - Fax:951-506-9113
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-01-12
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Provider Licenses
StateLicense IDTaxonomies
AZ354902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI44266Medicare UPIN