Provider Demographics
NPI:1639299498
Name:ROSENTHAL, BRIAN JEFFREY (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JEFFREY
Last Name:ROSENTHAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:99 N LA CIENEGA BLVD
Mailing Address - Street 2:STE #102
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211
Mailing Address - Country:US
Mailing Address - Phone:310-274-1300
Mailing Address - Fax:310-861-0227
Practice Address - Street 1:99 N LA CIENEGA BLVD
Practice Address - Street 2:STE #102
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-274-1300
Practice Address - Fax:310-861-0227
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67134208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G67134Medicare UPIN