Provider Demographics
NPI:1093909384
Name:N. PAUL ROSENTHAL M.D. INC.
Entity Type:Organization
Organization Name:N. PAUL ROSENTHAL M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:818-995-1174
Mailing Address - Street 1:17525 VENTURA BLVD.
Mailing Address - Street 2:SUITE # 203
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5109
Mailing Address - Country:US
Mailing Address - Phone:818-995-1175
Mailing Address - Fax:818-638-5762
Practice Address - Street 1:17525 VENTURA BLVD.
Practice Address - Street 2:SUITE # 203
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5109
Practice Address - Country:US
Practice Address - Phone:818-995-1175
Practice Address - Fax:818-638-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC334412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1316969843OtherMEDICARE IND NPI
CAC33441OtherSTATE LICENSE
CA1316969843OtherMEDICARE IND NPI