Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G42241 | CA |
NPI | 1013959097 |
---|---|
Provider Name | Dr. David A Rosenberg |
First Address | Seal Beach, CA 90740-8170 |
Second Address | Los Alamitos, CA 90720-6702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 18/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G422411 | (05) | CA |
100013780001 | BLUE SHIELD OF CA (01) | |
199557500 | US DEPT OF LABOR (ASC) (01) | |
A48876 | (02) | CA |