Individual ProviderRosemarie LaraNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address300 Medical Plaza, #200, Los Angeles, CA 90095-0001(310) 825-5111(310) 968-9277PECOS EnrollmentBased on the most recent information from CMS, provider Rosemarie Lara does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1831112754Provider TypeIndividualFull NameLara, RosemarieCredentialNPGenderFemaleSole ProprietorNoEnumeration Date7/25/2006Last Updated11/3/2011Contact InformationPractice LocationPractice Address300 Medical Plaza, #200, Los Angeles, CA 90095-0001Phone(310) 825-5111FaxUnlisted FaxMailing LocationMailing Address11755 Palms Blvd, Los Angeles, CA 90066-2030Phone(310) 968-9277FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN508763CaliforniaCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP13828CaliforniaProvider IdentifiersIDDescriptionIssuerIDRN508763DescriptionMedicaidIssuerUnlistedCalifornia