Healthcare Provider Details

I. General information

NPI: 1952729428
Provider Name (Legal Business Name): ROSNY LAURENT DANIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE M24
SAN FRANCISCO CA
94143
US

IV. Provider business mailing address

505 PARNASSUS AVE ROOM M-24
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1529
  • Fax:
Mailing address:
  • Phone: 415-353-1529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberD6015092
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA140849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: