Provider Demographics
NPI:1245473677
Name:MARK C. ROTHMAN, M. D., INC.
Entity type:Organization
Organization Name:MARK C. ROTHMAN, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-244-8200
Mailing Address - Street 1:371 VAN NESS WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-6297
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-503-4977
Practice Address - Street 1:436 N BEDFORD DR STE 102
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4323
Practice Address - Country:US
Practice Address - Phone:310-385-8819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83051207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty