Mark A Rosa, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

8575T Issued in CA

Practice address

23300 Sunnymead Blvd Ste a
Moreno Valley, CA 92553-4533

Phone

(951) 242-3937

Fax

(951) 247-4649

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mark Rosa Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1932274867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 SUNNYMEAD BLVD STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534533",
            "telephone_number": "951-242-3937",
            "fax_number": "951-247-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23300 SUNNYMEAD BLVD STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534533",
            "telephone_number": "951-242-3937",
            "fax_number": "951-247-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8575T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "ROSA",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Allison Kate Romin
• Cristina Michelle Romo
• Denise Flores Romo, CLINICAL PSYCHOLOGY
• Stephanie Romo
• Rophets Dialysis LLC
• Myrysha Rosa, ACSW, PPSC
• Angelica Rosales
• Rosemarie Tweed, D.O., Apc
• Angela L Rosenblatt, M.S., PHARM.D., BCPS
• Jeffrey Robert Rosenblatt, PHARMD, BCPS, BCNSP

• Optometrist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.