Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G37045 | CA |
NPI | 1235167107 |
---|---|
Provider Name | Dr. Samuel R Rosenfeld |
First Address | Orange, CA 92868-3854 |
Second Address | Orange, CA 92868-3854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 07/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ES394Y | INDIVIDUAL PTAN (01) | CA |