Individual provider Active NPI

David A Rosenberg, M.D.

  • Neurology Physician
  • Los Alamitos, CA
National Provider Identifier
1013959097
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G42241 Issued in CA
Practice address
10941 Bloomfield St Ste a
Los Alamitos, CA 90720-6702
Phone
(562) 598-7780
Fax
(562) 598-2283
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G42241 CA Primary

Addresses

Primary practice location

10941 Bloomfield St Ste a
Los Alamitos, CA 90720-6702

Mailing address

PO Box 4170
Seal Beach, CA 90740-8170
Phone (562) 598-7780

Other identifiers 3

IdentifierTypeStateIssuer
100013780001OtherBLUE SHIELD OF CA
199557500OtherUS DEPT OF LABOR (ASC)
00G422411MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000830 CA Practitioner - Neurology 4284892720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
David a. Rosenberg, M.D., Inc Specialist CurrentSince Jan 14, 2012 Accepting new patients

Locations

3771 Katella Ave
Ste 201
Los Alamitos, CA 90720
Phone (562) 534-2606

4281 Katella Ave
Ste 100
Los Alamitos, CA 90720
Phone (562) 598-7780

10941 Bloomfield St
Ste A
Los Alamitos, CA 90720
Phone (562) 596-1667

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1013959097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4170",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907408170",
            "telephone_number": "562-598-7780",
            "fax_number": "562-598-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10941 BLOOMFIELD ST STE A",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206702",
            "telephone_number": "562-598-7780",
            "fax_number": "562-598-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G42241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "100013780001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR (ASC)",
            "identifier": "199557500",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G422411",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.