Provider Demographics
NPI:1639388135
Name:BARRY ROTMAN MD INC
Entity Type:Organization
Organization Name:BARRY ROTMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-296-9228
Mailing Address - Street 1:1535 TREAT BLVD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1043
Mailing Address - Country:US
Mailing Address - Phone:925-296-9228
Mailing Address - Fax:925-296-9227
Practice Address - Street 1:1535 TREAT BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1043
Practice Address - Country:US
Practice Address - Phone:925-296-9228
Practice Address - Fax:925-296-9227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEIN NUMBER