Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 6360381-1205 | UT |
N | 207VE0102X | Reproductive Endocrinologist | 38404 | IA |
N | 207VE0102X | Reproductive Endocrinologist | A119897 | CA |
Y | 207VX0000X | Obstetrician | 38404 | IA |
NPI | 1114114584 |
---|---|
Provider Name | Evan Rosenbluth |
First Address | San Ramon, CA 94583 |
Second Address | Orinda, CA 94563-3031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2007 |
Last Update Date | 10/03/2014 |