Organization Active NPI

Rosaasen Physical Medicine Inc

  • General Practice Physician
  • Simi Valley, CA
National Provider Identifier
1255651113
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A85781 Issued in CA
Legal business name
ROSAASEN PHYSICAL MEDICINE INC
Practice address
2780 Tapo Canyon Rd
Suite A3
Simi Valley, CA 93063-6840
Phone
(805) 520-2929
Fax
(805) 520-2948
NPI assigned
Jun 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Authorized official

Name
Leah R Gladden, D.C.NPI 1407890833
Title
President
Phone
(805) 520-2929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 25341 CA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 27915 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A85781 CA Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 22683 CA

Addresses

Primary practice location

2780 Tapo Canyon Rd
Suite A3
Simi Valley, CA 93063-6840

Mailing address

2780 Tapo Canyon Rd
Suite A3
Simi Valley, CA 93063-6840
Phone (805) 520-2929

National Provider Directory

National Provider Directory

Locations

990 Enchanted Way
#101A
Simi Valley, CA 93065
Phone (805) 520-2929

2780 Tapo Canyon Rd
Ste A3
Simi Valley, CA 93063
Phone (805) 520-2929

990 Enchanted Way
Ste 101A
Simi Valley, CA 93065
Phone (805) 520-2929

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1255651113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 TAPO CANYON RD",
            "address_2": "SUITE A3",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930636840",
            "telephone_number": "805-520-2929",
            "fax_number": "805-520-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 TAPO CANYON RD",
            "address_2": "SUITE A3",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930636840",
            "telephone_number": "805-520-2929",
            "fax_number": "805-520-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSAASEN PHYSICAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "GLADDEN",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-520-2929",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "25341",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "27915",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A85781",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.