Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A46282 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A46282 | CA |
N | 207NS0135X | Procedural Dermatology | A46282 | CA |
NPI | 1164560637 |
---|---|
Provider Name | Alan Rosenbach |
First Address | Century City, CA 90067-2001 |
Second Address | Century City, CA 90067-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2007 |
Last Update Date | 07/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G52806 | (02) | CA |