Organization Active NPI

Rosen Medical Group Inc

  • Internal Medicine Physician
  • Calabasas, CA
National Provider Identifier
1174162283
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROSEN MEDICAL GROUP INC
Practice address
23621 Park Sorrento Ste 102
Calabasas, CA 91302-1395
Phone
(818) 797-8000
Fax
(818) 797-7799
NPI assigned
Jan 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Bobbie Brito
Title
Supervisor
Phone
(818) 799-4454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

23621 Park Sorrento Ste 102
Calabasas, CA 91302-1395

Mailing address

23621 Park Sorrento Ste 102
Calabasas, CA 91302-1395
Phone (818) 797-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200502000197 CA Part B Supplier - Clinic/Group Practice 9830520055 Receives reassigned benefits from 1 practitioner
Practice locations: Calabasas, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2205385Rosen Medical Group23621 Park Sorento #102, Calabasas, CA 91302Certificate of waiverDec 13, 2026

National Provider Directory

National Provider Directory

Locations

23621 Park Sorrento
Ste 102
Calabasas, CA 91302
Phone (818) 797-8000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1174162283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23621 PARK SORRENTO STE 102",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021395",
            "telephone_number": "818-797-8000",
            "fax_number": "818-797-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23621 PARK SORRENTO STE 102",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021395",
            "telephone_number": "818-797-8000",
            "fax_number": "818-797-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "BRITO",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "818-799-4454"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.