Provider Demographics
NPI:1104868363
Name:ROSENBAUM, LOUIS J (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4232 E CACTUS RD
Mailing Address - Street 2:STE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-996-4850
Mailing Address - Fax:602-996-0089
Practice Address - Street 1:4232 E CACTUS RD
Practice Address - Street 2:STE 108
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-996-4850
Practice Address - Fax:602-996-0089
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ05042207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37540Medicare UPIN