1437568987 NPI number — DR. WHITNEY LEIGH ROSILEZ PHARMD

Table of content: DR. WHITNEY LEIGH ROSILEZ PHARMD (NPI 1437568987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437568987 NPI number — DR. WHITNEY LEIGH ROSILEZ PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSILEZ
Provider First Name:
WHITNEY
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHARP
Provider Other First Name:
WHITNEY
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437568987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9445 MOUNTAIN VIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATASCADERO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93422-5012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-400-8158
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1168 W BRANCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARROYO GRANDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93420-1906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-474-0900
Provider Business Practice Location Address Fax Number:
805-474-8947
Provider Enumeration Date:
08/08/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  47580 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)