Provider Demographics
NPI:1851656029
Name:ROSENSTOCK, LYNN B (MD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:B
Last Name:ROSENSTOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 E CHARLESTON RD
Mailing Address - Street 2:APT. K-306
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4644
Mailing Address - Country:US
Mailing Address - Phone:650-223-7083
Mailing Address - Fax:650-854-4786
Practice Address - Street 1:899 E CHARLESTON RD
Practice Address - Street 2:APT. K-306
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4644
Practice Address - Country:US
Practice Address - Phone:650-223-7083
Practice Address - Fax:650-854-4786
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG12836207Q00000X
CAG12835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine