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General NPI Number Information
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NPI Number | 1265552129
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Entity Type | Organization
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Legal Business Name | JOSEPH A. ROTHSTEIN SPEECH PATHOLOGY, P.C.
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Dates
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Enumeration Date | 04/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1933 12TH ST APT. A
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City | SANTA MONICA
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State | CA
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Zip | 90404-4649
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Country | US
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Telephone | 310-487-5142
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Fax | 310-399-2264
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Provider Business Mailing Address
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Address Line | 1247 LINCOLN BLVD #284
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City | SANTA MONICA
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State | CA
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Zip | 90401-1703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH A. ROTHSTEIN
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Credential | MS, CCC-SLP
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Telephone | 310-487-5142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12842
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License Number State | CA
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