Provider Demographics
NPI:1811084536
Name:ROSENTHAL, MARK J (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16111 PLUMMER ST
Mailing Address - Street 2:11E
Mailing Address - City:SEPULVEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2036
Mailing Address - Country:US
Mailing Address - Phone:818-891-7711
Mailing Address - Fax:818-895-9519
Practice Address - Street 1:16111 PLUMMER ST
Practice Address - Street 2:11E
Practice Address - City:SEPULVEDA
Practice Address - State:CA
Practice Address - Zip Code:91343-2036
Practice Address - Country:US
Practice Address - Phone:818-891-7711
Practice Address - Fax:818-895-9519
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG37423174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist