Healthcare Provider Details

I. General information

NPI: 1346224466
Provider Name (Legal Business Name): SUZANNE ROSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 ABBOTT ST 100
SALINAS CA
93901-4483
US

IV. Provider business mailing address

355 ABBOTT ST 100
SALINAS CA
93901-4483
US

V. Phone/Fax

Practice location:
  • Phone: 831-751-7070
  • Fax: 831-751-7050
Mailing address:
  • Phone: 831-751-7070
  • Fax: 831-751-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA71819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: