Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | G49400 | CA |
NPI | 1073654083 |
---|---|
Provider Name | John E Rosenman |
First Address | Los Altos, CA 94022-1408 |
Second Address | Burlingame, CA 94010-4506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2007 |
Last Update Date | 19/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A51356 | (02) | CA |
G049400 | LICENSE (01) | CA |
YYY34803Y | (05) | CA |