Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A52229 | CA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | A52229 | CA |
NPI | 1164526448 |
---|---|
Provider Name | Mr. Joseph Rosenthal |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A522290 | (05) | CA |
G22990 | (02) |