Provider Demographics
NPI:1396816864
Name:ROSENBLUM, ALAN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEE
Last Name:ROSENBLUM
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 1:2415 BATH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4324
Mailing Address - Country:US
Mailing Address - Phone:805-569-2004
Mailing Address - Fax:805-682-1384
Practice Address - Street 1:2415 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4324
Practice Address - Country:US
Practice Address - Phone:805-569-2004
Practice Address - Fax:805-682-1384
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19352207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G193520Medicaid
CA00G193520Medicaid
CAA90593Medicare UPIN