Basic Information
| Provider Information | |||||||||
| NPI: | 1992749972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSTOW | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | WARREN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2067 W VISTA WAY | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920836031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608065700 | ||||||||
| FaxNumber: | 7609454662 | ||||||||
| Practice Location | |||||||||
| Address1: | 2067 W VISTA WAY | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920836031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7608065700 | ||||||||
| FaxNumber: | 7609454662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | G36385 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.