Provider Demographics
NPI:1073387825
Name:ROBERT ROSETT
Entity Type:Organization
Organization Name:ROBERT ROSETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-262-2969
Mailing Address - Street 1:6236 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3144
Mailing Address - Country:US
Mailing Address - Phone:650-223-4208
Mailing Address - Fax:833-563-2266
Practice Address - Street 1:15061 SPRINGDALE ST STE 110
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1103
Practice Address - Country:US
Practice Address - Phone:831-262-2969
Practice Address - Fax:833-563-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty