Basic Information
| Provider Information | |||||||||
| NPI: | 1184603417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSBRUGH | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 20577 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933900577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613268021 | ||||||||
| FaxNumber: | 6613268022 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 OLD RIVER RD | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933119781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616636275 | ||||||||
| FaxNumber: | 6613268022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 05/10/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | G81127 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00G811270 | 05 | CA | MEDICAID | AN923Y | 01 | CA | MEDICARE PTAN-TRUXTUN | OTHER | AN923Z | 01 | CA | MEDICARE PTAN-SOUTHWEST | OTHER |