MEDICARE: STEVEN L ROSENBLATT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A53639	CA

General Provider Information

NPI Number	:	1134142201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN L ROSENBLATT M.D.

Provider Business Mailing Address
First Line	:	11600 WILSHIRE BLVD
Second Line	:	SUITE 320
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1783
Country	:	US
Telephone Number	:	310-559-8276
Fax Number	:	310-559-8263

Provider Business Practice Location Address
First Line	:	1655 N MOUNT VERNON AVE STE B1
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-1427
Country	:	US
Telephone Number	:	909-586-6260
Fax Number	:	909-586-6262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/16/2017

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