Provider Demographics
NPI:1588797658
Name:DR. MURRAY M. ROSENBERG, P.C.
Entity Type:Organization
Organization Name:DR. MURRAY M. ROSENBERG, P.C.
Other - Org Name:TENAYA FAMILY PRACTICE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-838-0400
Mailing Address - Street 1:2481 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0832
Mailing Address - Country:US
Mailing Address - Phone:702-838-0400
Mailing Address - Fax:702-838-0050
Practice Address - Street 1:2481 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0832
Practice Address - Country:US
Practice Address - Phone:702-838-0400
Practice Address - Fax:702-838-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV32296Medicare ID - Type UnspecifiedMEDICARE GRP NUMBER