Basic Information
| Provider Information | |||||||||
| NPI: | 1942444302 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOEL S. ROSEN, MD, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18300 ROSCOE BLVD | ||||||||
| Address2: | IFL 4TH FLOOR | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188855342 | ||||||||
| FaxNumber: | 8187271451 | ||||||||
| Practice Location | |||||||||
| Address1: | 18300 ROSCOE BLVD | ||||||||
| Address2: | IFL 4TH FLOOR | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185588342 | ||||||||
| FaxNumber: | 8187271451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2009 | ||||||||
| LastUpdateDate: | 07/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | SHIRLEY | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLER | ||||||||
| AuthorizedOfficialTelephone: | 8188855342 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273Y00000X | G013193 | CA | Y | Hospital Units | Rehabilitation Unit |
No ID Information.