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General NPI Number Information
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NPI Number | 1639226848
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Entity Type | Individual
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Provider Name | MR. MICHAEL ELIAS ROSENBAUM
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7200 BANCROFT AVE EASTMONT TOWN CENTER BLDG. B. SUITE 133
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City | OAKLAND
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State | CA
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Zip | 94605-2403
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Country | US
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Telephone | 510-553-8500
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Fax | 510-553-8550
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Provider Business Mailing Address
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Address Line | 16077 ASHLAND AVE APT. NO. 396
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City | SAN LORENZO
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State | CA
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Zip | 94580-1158
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Country | US
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Telephone | 510-553-8500
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Fax | 510-553-8550
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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