MEDICARE: GREGORY F. ROSEN 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	207VE0102X	Reproductive Endocrinology Physician	G054762	CA

General Provider Information

NPI Number	:	1285720417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY F. ROSEN M.D.

Provider Business Mailing Address
First Line	:	13950 MILTON AVE
Second Line	:	SUITE 402
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-2900
Country	:	US
Telephone Number	:	714-702-3000
Fax Number	:	714-702-3030

Provider Business Practice Location Address
First Line	:	13950 MILTON AVE
Second Line	:	SUITE 100
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-2900
Country	:	US
Telephone Number	:	714-702-3000
Fax Number	:	714-702-3030

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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