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General NPI Number Information
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NPI Number | 1972519668
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Entity Type | Individual
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Provider Name | MARTIN I ROTMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9911 W PICO BLVD SUITE 1500
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City | LOS ANGELES
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State | CA
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Zip | 90035-2703
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Country | US
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Telephone | 310-843-0909
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Fax | 310-551-1322
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Provider Business Mailing Address
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Address Line | 10321 ROCHESTER AVE
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City | LOS ANGELES
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State | CA
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Zip | 90024-5353
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Country | US
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Telephone | 310-551-0722
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Fax | 310-551-1322
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 27364
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License Number State | CA
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