Provider Demographics
NPI:1215215231
Name:PAUL D. ROSENBLIT, M.D., INC
Entity Type:Organization
Organization Name:PAUL D. ROSENBLIT, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:NI
Authorized Official - Middle Name:
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-375-5572
Mailing Address - Street 1:18821 DELAWARE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1926
Mailing Address - Country:US
Mailing Address - Phone:714-375-5572
Mailing Address - Fax:714-375-5575
Practice Address - Street 1:18821 DELAWARE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1926
Practice Address - Country:US
Practice Address - Phone:714-375-5572
Practice Address - Fax:714-375-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1699862102OtherNPI
CAA85262Medicare UPIN