| Organization Name: | GUSTAVO A ROSALES MD, INC |
| NPI Number: | 1528270063 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GUSTAVO A ROSALES (OWNER) |
| Mailing Address: | 5385 Franklin Blvd Suite K Sacramento |
| State: | CA US |
| Postal Code: | 95820 |
| Phone Number: | 9164280656 |
| Fax Number: | 9164283763 |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 07/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A414750 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |