NPIMap

Individual provider Active NPI

Daniel M. Rose, MD

  • Family Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1285668962
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A44506 Issued in CA
Practice address
14435 Hamlin St
Suite #104
Van Nuys, CA 91401-6205
Phone
(714) 345-8427
Fax
(818) 855-1254
NPI assigned
Jul 10, 2006
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A44506 CA Primary

Addresses

Primary practice location

14435 Hamlin St
Suite #104
Van Nuys, CA 91401-6205

Mailing address

14435 Hamlin St
Suite #104
Van Nuys, CA 91401-6205
Phone (714) 345-8427

Other names 1

  • Kimberly Clark Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051028000262 CA Practitioner - Family Practice 7012934151 Reassigns benefits to 3 organizations
Practice locations: Van Nuys, CA; North Hollywood, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44506CAMDGeneral Practice Dentistry
A44506CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erx Medical Group Inc CurrentSince Mar 20, 2025 Accepting new patients
Well Health Medical Clinic Inc Family Medicine CurrentSince Nov 25, 2024 Accepting new patients
Valley Clinica Medica General Medical Center Inc Family Medicine Past Accepting new patients
Valley Clinica Medica General Medical Center Inc Family Medicine Past Accepting new patients
Peter T Katsiyiannis, MD, Inc. Past Accepting new patients
Valley Clinica Medica General Medical Center Inc Family Medicine Past Accepting new patients

Locations

14434 Hamlin St
Ste 2A
Van Nuys, CA 91401
Phone (818) 809-2444

14435 Hamlin St
Ste 104
Van Nuys, CA 91401
Phone (818) 855-1244

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
General Care Group IncNorth Hollywood, CA, CCN B51767 Hospice Contracted Managing Employee Mar 1, 2026
HFS Hospice Care IncVan Nuys, CA, CCN B51530 Hospice Contracted Managing Employee Mar 1, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1285668962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14435 HAMLIN ST",
            "address_2": "SUITE #104",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016205",
            "telephone_number": "714-345-8427",
            "fax_number": "818-855-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14435 HAMLIN ST",
            "address_2": "SUITE #104",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016205",
            "telephone_number": "714-345-8427",
            "fax_number": "818-855-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DANIEL",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CLARK",
            "credential": "OFFICE MANAGER/MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.