De La Rosa, Heidelene E

De La Rosa, Heidelene E is an sole proprietor health care provider with primary practice located at 16125 Kamana Rd , Apple Valley CA 92307-1377. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. De La Rosa, Heidelene E can be contacted via phone (760) 946-2600.

Contact Information

Primary practice address
16125 Kamana Rd Apple Valley CA 92307-1377
Fax: (760) 946-5600
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036099009 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C52214 California

Profile Details

NPI number 1154378693
LBN Legal business name De La Rosa, Heidelene E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated May 4th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154378693 NPPES
Illinois MEDICAID 0360990099
Illinois MEDICAID 1154378693

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