Provider Demographics
NPI:1114052313
Name:BELLOWS & ROSEN, INC.
Entity Type:Organization
Organization Name:BELLOWS & ROSEN, INC.
Other - Org Name:BMCP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-421-2560
Mailing Address - Street 1:678 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1922
Mailing Address - Country:US
Mailing Address - Phone:650-421-2560
Mailing Address - Fax:650-421-2560
Practice Address - Street 1:678 MAIN ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1922
Practice Address - Country:US
Practice Address - Phone:650-421-2560
Practice Address - Fax:650-421-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER