Provider Demographics
NPI:1356626766
Name:ROZENBERG, EDWARD (LAC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:ROZENBERG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 WHITTIER BLVD
Mailing Address - Street 2:400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-4038
Mailing Address - Country:US
Mailing Address - Phone:323-728-8222
Mailing Address - Fax:
Practice Address - Street 1:5301 WHITTIER BLVD # 401
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4038
Practice Address - Country:US
Practice Address - Phone:323-728-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist