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NPI Code Detail

MEDICARE: DR. ROBERT MATTHEW ROSSI D.D.S.

MEDICARE:  DR. ROBERT MATTHEW ROSSI  D.D.S.
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
11223G0001XGeneral Practice Dentistry30625CA

General Provider Information

NPI Number : 1386729259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT MATTHEW ROSSI D.D.S.
Provider Business Mailing Address
First Line : 5363 BALBOA BLVD
Second Line : SUITE 528
City : ENCINO
State : CA
Zip : 91316-2809
Country : US
Telephone Number : 818-788-6810
Fax Number : 818-788-2852
Provider Business Practice Location Address
First Line : 5363 BALBOA BLVD
Second Line : SUITE 528
City : ENCINO
State : CA
Zip : 91316-2809
Country : US
Telephone Number : 818-788-6810
Fax Number : 818-788-2852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ROBERT MATTHEW ROSSI D.D.S.” Practice Location

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