| Doctor Name: | IVAN W ROSEN |
| NPI Number: | 1588687255 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C24928 |
| Business Practice Address: | 1115 S Sunset Ave West Covina, CA - 917903940 |
| Business Phone Number: | 6268142540 |
| Business Fax Number: | 6268142540 |
| Mailing Address: | Po Box 635, WEST COVINA |
| State: | CA |
| Postal Code: | 917930635 |
| Phone Number: | 6268139988 |
| Fax Number: | 6268130049 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | C24928 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |