Healthcare Provider Details
I. General information
NPI: 1528424371
Provider Name (Legal Business Name): LESLIE ANNE ROSENTHAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2016
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US
IV. Provider business mailing address
3250 WILSHIRE BLVD STE 1101
LOS ANGELES CA
90010-1513
US
V. Phone/Fax
- Phone: 323-361-2122
- Fax:
- Phone: 323-660-2450
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A135613 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: