Healthcare Provider Details

I. General information

NPI: 1164470126
Provider Name (Legal Business Name): MICHAEL A. ROSENZWEIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DUARTE RD
DUARTE CA
91010-3012
US

IV. Provider business mailing address

1333S MAYFLOWER AVE 2ND FLOOR
MONROVIA CA
91016-4066
US

V. Phone/Fax

Practice location:
  • Phone: 626-256-4673
  • Fax: 626-301-8256
Mailing address:
  • Phone: 626-775-3514
  • Fax: 626-408-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA118217
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: