MEDICARE: ADAM M. ROTUNDA, M.D., A PROFESSIONAL CORPORATION

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	207ND0101X	MOHS-Micrographic Surgery Physician	A81640	CA

General Provider Information

NPI Number	:	1700035946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAM M. ROTUNDA, M.D., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1100 QUAIL ST STE 102
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2702
Country	:	US
Telephone Number	:	949-336-7171
Fax Number	:	949-336-7172

Provider Business Practice Location Address
First Line	:	1100 QUAIL ST STE 102
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2702
Country	:	US
Telephone Number	:	949-336-7171
Fax Number	:	949-336-7172

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ADAM MICHAEL ROTUNDA
Credential	:	M.D.
Telephone Number	:	949-336-7171

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	12/03/2025

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