Provider Demographics
NPI:1588648968
Name:ROSENFIELD, A. LYLE (MD)
Entity Type:Individual
Prefix:
First Name:A.
Middle Name:LYLE
Last Name:ROSENFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4130 LA JOLLA VILLAGE DR
Mailing Address - Street 2:STE 306
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1481
Mailing Address - Country:US
Mailing Address - Phone:858-455-6460
Mailing Address - Fax:858-455-7197
Practice Address - Street 1:4130 LA JOLLA VILLAGE DR
Practice Address - Street 2:STE 306
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1481
Practice Address - Country:US
Practice Address - Phone:858-455-6460
Practice Address - Fax:858-455-7197
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG75293207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF59880Medicare UPIN
CA0443010001Medicare NSC