| Organization Name: | GUSTAVO A. ROSALES, MD, INC. |
| NPI Number: | 1538332234 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GUSTAVO A ROSALES (OWNER) |
| Mailing Address: | 7275 E Southgate Dr Suite 102 Sacramento |
| State: | CA US |
| Postal Code: | 958232628 |
| Phone Number: | 9164280656 |
| Fax Number: | 9164283763 |
| NPI Enumeration Date: | 04/02/2008 |
| NPI Last Update Date: | 03/31/2009 |
| 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: | |