Provider Demographics
NPI:1346332293
Name:KAY, ROSANNE (MD)
Entity Type:Individual
Prefix:
First Name:ROSANNE
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSANNE
Other - Middle Name:
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3215 N SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2453
Mailing Address - Country:US
Mailing Address - Phone:424-295-0540
Mailing Address - Fax:
Practice Address - Street 1:3215 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2453
Practice Address - Country:US
Practice Address - Phone:424-295-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80428207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G804280Medicaid
CAHG80428B0Medicaid
CAHG80428BMedicare PIN
F30062Medicare UPIN