Healthcare Provider Details

I. General information

NPI: 1528970035
Provider Name (Legal Business Name): ROSEN RUMENOV PETROV
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 E VERDUGO AVE
BURBANK CA
91501-1513
US

IV. Provider business mailing address

927 E VERDUGO AVE
BURBANK CA
91501-1513
US

V. Phone/Fax

Practice location:
  • Phone: 310-756-4054
  • Fax:
Mailing address:
  • Phone: 310-756-4054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number94387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: