Provider Demographics
NPI:1942368394
Name:ROVEN, ALFRED N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:N
Last Name:ROVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3681
Mailing Address - Country:US
Mailing Address - Phone:323-937-7733
Mailing Address - Fax:323-937-7740
Practice Address - Street 1:5757 WILSHIRE BLVD
Practice Address - Street 2:SUITE #6
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3681
Practice Address - Country:US
Practice Address - Phone:323-937-7733
Practice Address - Fax:323-937-7740
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37043207Y00000X, 208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Not Answered2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46924Medicare UPIN
CAG37043Medicare ID - Type Unspecified