Provider Demographics
NPI:1770618548
Name:ROSENBERG, DAVID SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SAMUEL
Last Name:ROSENBERG
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 1:145 N ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2103
Mailing Address - Country:US
Mailing Address - Phone:310-295-7925
Mailing Address - Fax:310-492-0484
Practice Address - Street 1:145 N ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2103
Practice Address - Country:US
Practice Address - Phone:310-295-7925
Practice Address - Fax:310-492-0484
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108794208200000X
CAA92453208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA92453AMedicare PIN
AZ116703Medicare PIN