Provider Demographics
NPI:1326225764
Name:STEVEN H ROSENBERG MD INC
Entity Type:Organization
Organization Name:STEVEN H ROSENBERG MD INC
Other - Org Name:STEVEN H ROSENBERG MD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-539-4957
Mailing Address - Street 1:3400 LOMITA BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4909
Mailing Address - Country:US
Mailing Address - Phone:310-539-4957
Mailing Address - Fax:310-539-9175
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-539-4957
Practice Address - Fax:310-539-9175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G342337261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47002Medicare UPIN
CA00G372331Medicare PIN