Provider Demographics
NPI:1053498873
Name:ROSENFELD, IRWIN IRA (MD)
Entity Type:Individual
Prefix:MR
First Name:IRWIN
Middle Name:IRA
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23121 PLAZA POINTE DR
Mailing Address - Street 2:#150
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-837-7071
Mailing Address - Fax:949-837-5002
Practice Address - Street 1:23121 PLAZA POINTE DR
Practice Address - Street 2:#150
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-837-7071
Practice Address - Fax:949-837-5002
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG347312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46050Medicare UPIN
G34731Medicare ID - Type Unspecified