Provider Demographics
NPI:1154668010
Name:ALAN ROSENBACH MD INC
Entity Type:Organization
Organization Name:ALAN ROSENBACH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-556-5454
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 1704
Mailing Address - City:CENTURY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-556-5454
Mailing Address - Fax:310-556-5451
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 1704
Practice Address - City:CENTURY CITY
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-556-5454
Practice Address - Fax:310-556-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty