Healthcare Provider Details

I. General information

NPI: 1427190735
Provider Name (Legal Business Name): JEANNE LILA ROSNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

250 WINDING WAY
WOODSIDE CA
94062-2539
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-5725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberG80180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: