Robert Rosenberg, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

G50480 Issued in CA

Practice address

2720 N Harbor Blvd
Suite 210
Fullerton, CA 92835-2609

Phone

(714) 626-6310

Fax

(714) 626-6320

NPI assigned

Aug 2, 2005

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: rrosenberg1374304@oc.providencedirect.org

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1265433072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 210",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD",
            "address_2": "SUITE 210",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352609",
            "telephone_number": "714-626-6310",
            "fax_number": "714-626-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15855 Pomona Rincon Rd",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917095572",
            "country_code": "US",
            "telephone_number": "909-929-2514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G50480",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G50480",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G50480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rrosenberg1374304@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "955 W Imperial Hwy Ste 200",
            "city": "Brea",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928213812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ana Rose
• Malique Rose
• Susan Lynette Roseli, LVN
• Melissa Rosen, CCC
• Alexandra Rosenberg, LMFT
• Dale M Rosenblum, DPM
• Michael Allen Rosendo
• Johanna Lynn Rosenthal, M.D.
• Dorothy Masae Rosero, 4406
• Darrion Tisshaun Ross

• MOHS-Micrographic Surgery Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• MOHS-Micrographic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.