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NPI Code Detail

MEDICARE: LISA JANET ROSENBAUM MA

MEDICARE:   LISA JANET ROSENBAUM  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist9233CA

General Provider Information

NPI Number : 1548807720
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA JANET ROSENBAUM MA
Provider Business Mailing Address
First Line : 1704 HERRIN ST
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2828
Country : US
Telephone Number : 310-892-7734
Fax Number :
Provider Business Practice Location Address
First Line : 1704 HERRIN ST
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90278-2828
Country : US
Telephone Number : 310-374-7734
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2019
Last Update Date : 12/05/2019

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Directions to “ LISA JANET ROSENBAUM MA” Practice Location

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