Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G143954 | CA |
N | 208800000X | Urologist | ME68557 | FL |
NPI | 1013948959 |
---|---|
Provider Name | Evan G Rosen |
First Address | North Hollywood, CA 91606-2924 |
Second Address | North Hollywood, CA 91606-2924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 01/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16933 | WELLCARE (01) | FL |
203920 | AVMED (01) | FL |
27150 | BCBS (01) | FL |
3781724 | CIGNA (01) | FL |
5301 | DIMENSION HEALTH PPO (01) | FL |
5898115 | AETNA (01) | FL |
P968835 | OPTIMUM (01) | FL |
P988893 | FREEDOM (01) | FL |
S817401 | CAREPLUS (01) | FL |