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General NPI Number Information
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NPI Number | 1164441960
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Entity Type | Individual
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Provider Name | KENNETH EVAN ROSENFELD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD VAGLAHS (MAIL CODE 111G)
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-478-3711
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Fax | 310-268-4933
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Provider Business Mailing Address
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Address Line | 1825 4TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2350
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Country | US
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Telephone | 415-885-7671
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Fax | 415-353-9522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G78614
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | G78614
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License Number State | CA
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