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General NPI Number Information
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NPI Number | 1396701629
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Entity Type | Individual
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Provider Name | BARRY ROTHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4105
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Country | US
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Telephone | 818-885-8500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | SIMI VALLEY
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State | CA
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Zip | 93062-0190
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Country | US
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Telephone | 805-522-5940
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Fax | 805-522-6401
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G19383
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License Number State | CA
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