Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | G28250 | CA |
NPI | 1194838813 |
---|---|
Provider Name | Dr. Stephen Gary Rosenbaum |
First Address | San Francisco, CA 94118-1522 |
Second Address | San Francisco, CA 94118-1522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A43666 | (02) | CA |