Healthcare Provider Details

I. General information

NPI: 1124280896
Provider Name (Legal Business Name): JOSHUA DANIEL ROSENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 02/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 LOMA VISTA RD BLDG 340 STE 501
VENTURA CA
93003-3099
US

IV. Provider business mailing address

2323 KNOLL DR STE 219
VENTURA CA
93003-7307
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6218
  • Fax: 805-652-6512
Mailing address:
  • Phone: 805-677-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA107148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: