Healthcare Provider Details

I. General information

NPI: 1629172614
Provider Name (Legal Business Name): MARK S ROZENGURT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 GEARY BLVD
SAN FRANCISCO CA
94118
US

IV. Provider business mailing address

4225 GEARY BLVD
SAN FRANCISCO CA
94118
US

V. Phone/Fax

Practice location:
  • Phone: 415-751-7756
  • Fax: 415-751-7757
Mailing address:
  • Phone: 415-751-7756
  • Fax: 415-751-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA37948
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA37948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: