Healthcare Provider Details

I. General information

NPI: 1457280497
Provider Name (Legal Business Name): DAVID ROZENBLAT FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD STE 150
BEVERLY HILLS CA
90211-2171
US

IV. Provider business mailing address

14114 W OAK LN
VAN NUYS CA
91405-5482
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-4995
  • Fax:
Mailing address:
  • Phone: 818-469-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: