Provider Demographics
NPI:1881907087
Name:ROTELLO, JAMES P (LAC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:P
Last Name:ROTELLO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9400 BRIGHTON WAY STE 301
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4710
Mailing Address - Country:US
Mailing Address - Phone:310-273-1157
Mailing Address - Fax:310-247-9008
Practice Address - Street 1:9400 BRIGHTON WAY STE 301
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4710
Practice Address - Country:US
Practice Address - Phone:310-273-1157
Practice Address - Fax:310-247-9008
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA5865171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist