Provider Demographics
NPI:1720087141
Name:ROSENFIELD, MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ROSENFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 CLAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3029
Mailing Address - Country:US
Mailing Address - Phone:415-644-5265
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:559 CLAY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3029
Practice Address - Country:US
Practice Address - Phone:415-644-5265
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001580207Q00000X
CA20A14721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7111149Medicaid
WA7111149Medicaid
WAG59645Medicare UPIN