Healthcare Provider Details

I. General information

NPI: 1598061624
Provider Name (Legal Business Name): DAVID SAUL ROSENFELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2487 GLENDOWER AVE
LOS ANGELES CA
90027-1110
US

IV. Provider business mailing address

11121 SUN CENTER DR STE G
RANCHO CORDOVA CA
95670-6199
US

V. Phone/Fax

Practice location:
  • Phone: 323-660-7768
  • Fax:
Mailing address:
  • Phone: 323-660-7768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberG37044
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberG37044
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG37044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: