Provider Demographics
NPI:1508900887
Name:ROTMAN, ARON L (MD)
Entity Type:Individual
Prefix:DR
First Name:ARON
Middle Name:L
Last Name:ROTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4804 LAUREL CANYON BLVD
Mailing Address - Street 2:SUITE 174
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3717
Mailing Address - Country:US
Mailing Address - Phone:760-636-8326
Mailing Address - Fax:760-775-0776
Practice Address - Street 1:4804 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 174
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3717
Practice Address - Country:US
Practice Address - Phone:760-636-8326
Practice Address - Fax:760-775-0776
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2012-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG73976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF39752Medicare UPIN
CA00G739760Medicare PIN