Healthcare Provider Details

I. General information

NPI: 1831105873
Provider Name (Legal Business Name): DAVID B ROSENFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 BEVERLY BLVD SUITE 402
LOS ANGELES CA
90048-1864
US

IV. Provider business mailing address

8737 BEVERLY BLVD SUITE 402
LOS ANGELES CA
90048-1864
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-3580
  • Fax: 310-659-5830
Mailing address:
  • Phone: 310-854-3580
  • Fax: 310-659-5830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberG83845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: