Active NPI
Dale M Rosenblum, DPM
- Foot & Ankle Surgery Podiatrist
- Fullerton, CA
National Provider Identifier
1144211889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E1472
- Practice address
- 704 N Harbor Blvd
Fullerton, CA 92832-1520 - Phone
- (714) 525-8282
- Fax
- (714) 525-0141
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E1472 | CA | Primary |
Addresses
Primary practice location
704 N Harbor Blvd
Fullerton, CA 92832-1520
Mailing address
704 N Harbor Blvd
Fullerton, CA 92832-1520
Phone (714) 525-8282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1472 | CA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1144211889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 N HARBOR BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321520",
"telephone_number": "714-525-8282",
"fax_number": "714-525-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 N HARBOR BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321520",
"telephone_number": "714-525-8282",
"fax_number": "714-525-0141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBLUM",
"first_name": "DALE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E1472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.