Basic Information
| Provider Information | |||||||||
| NPI: | 1003144668 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSA | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BALDAUF | ||||||||
| OtherFirstName: | MAUREEN | ||||||||
| OtherMiddleName: | A | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4205 SAN FELIPE RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951351503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082381552 | ||||||||
| FaxNumber: | 4082381552 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 E REMINGTON DR | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083893600 | ||||||||
| FaxNumber: | 4083893600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2009 | ||||||||
| LastUpdateDate: | 03/08/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT36199 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.