Provider Demographics
NPI:1629304118
Name:ROTENBERG, REBECCA MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARGARET
Last Name:ROTENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1733
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-1733
Mailing Address - Country:US
Mailing Address - Phone:310-266-8406
Mailing Address - Fax:310-496-2758
Practice Address - Street 1:9437 OAKMORE RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4138
Practice Address - Country:US
Practice Address - Phone:310-266-8406
Practice Address - Fax:310-496-2758
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA050009208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA050009OtherMEDICAL BOARD OF CALIFORNIA