Provider Demographics
NPI:1205815073
Name:ROSENTHAL, PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1091
Mailing Address - Country:US
Mailing Address - Phone:661-324-0300
Mailing Address - Fax:661-324-4095
Practice Address - Street 1:2323 16TH ST STE 407
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3454
Practice Address - Country:US
Practice Address - Phone:661-741-0924
Practice Address - Fax:661-741-0930
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG89264207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4480063OtherAETNA
TNE65181Medicare UPIN
TN621795522OtherTAX ID
TN0640035OtherUNITED HEALTHCARE
TN3084229Medicare ID - Type Unspecified
TN1275337007OtherCIGNA