Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | G32922 | CA |
N | 207VG0400X | Gynecologist | G32922 | CA |
NPI | 1376643361 |
---|---|
Provider Name | Amy Rosenman |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90401-2857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 13/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G329220 | (05) | CA |
A91485 | (02) | CA |