Provider Demographics
NPI:1942495213
Name:ROZENBLAT, ZINOVI (MD)
Entity Type:Individual
Prefix:DR
First Name:ZINOVI
Middle Name:
Last Name:ROZENBLAT
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:PO BOX 6204
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-6204
Mailing Address - Country:US
Mailing Address - Phone:949-509-1613
Mailing Address - Fax:
Practice Address - Street 1:100 N 1ST ST
Practice Address - Street 2:APT 3
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3531
Practice Address - Country:US
Practice Address - Phone:949-509-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA994732084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110583OtherSID