MEDICARE: KEITH JOSEPH ROSING MD

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	207P00000X	Emergency Medicine Physician	G29490	CA

General Provider Information

NPI Number	:	1942251921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH JOSEPH ROSING MD

Provider Business Mailing Address
First Line	:	25 SHADE TREE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92603-0130
Country	:	US
Telephone Number	:	949-759-8161
Fax Number	:	949-854-1019

Provider Business Practice Location Address
First Line	:	25 SHADE TREE
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92603-0130
Country	:	US
Telephone Number	:	949-759-8161
Fax Number	:	949-854-1019

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

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	11/17/2008

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