Provider Demographics
NPI:1619390887
Name:VANESSA SHANA ROTHHOLTZ MD INC
Entity Type:Organization
Organization Name:VANESSA SHANA ROTHHOLTZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-850-0183
Mailing Address - Street 1:414 N CAMDEN DR STE 975
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4541
Mailing Address - Country:US
Mailing Address - Phone:818-850-0183
Mailing Address - Fax:310-201-9665
Practice Address - Street 1:414 N CAMDEN DR STE 975
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-926-1573
Practice Address - Fax:310-926-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty