Healthcare Provider Details

I. General information

NPI: 1184436651
Provider Name (Legal Business Name): EUGENE ROSENMAN MD LA CENTER FOR BEHAVIORAL HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20201 SHERMAN WAY STE 106
WINNETKA CA
91306-3269
US

IV. Provider business mailing address

20201 SHERMAN WAY STE 106
WINNETKA CA
91306-3269
US

V. Phone/Fax

Practice location:
  • Phone: 702-248-8866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: EUGENE ROSENMAN
Title or Position: OWNER
Credential: MD
Phone: 702-248-8866