Provider Demographics
NPI:1457469371
Name:ROTUNDA, ADAM MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MICHAEL
Last Name:ROTUNDA
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 1:50 TOWNSEND
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2820
Mailing Address - Country:US
Mailing Address - Phone:949-336-7288
Mailing Address - Fax:949-336-7172
Practice Address - Street 1:1100 QUAIL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2701
Practice Address - Country:US
Practice Address - Phone:949-336-7171
Practice Address - Fax:949-336-7172
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI72383Medicare UPIN
CAWA81640AMedicare PIN