Organization Active NPI

David a. Rosenberg, M.D., Inc

  • Specialist
  • Los Alamitos, CA
National Provider Identifier
1598887945
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G42241 Issued in CA
Legal business name
DAVID A. ROSENBERG, M.D., INC
Practice address
10941 Bloomfield St
Los Alamitos, CA 90720-2530
Phone
(562) 598-7780
Fax
(562) 598-7780
NPI assigned
Apr 5, 2007
Organization subpart
No

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

Authorized official

Name
Dr. David A Rosenberg, M.D.NPI 1013959097
Title
Owner
Phone
(562) 598-7780

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G42241 CA Primary

Addresses

Primary practice location

10941 Bloomfield St
Los Alamitos, CA 90720-2530

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00G422411MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000834 CA Part B Supplier - Clinic/Group Practice 6002074549 Receives reassigned benefits from 1 practitioner
Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory

Locations

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

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

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": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1598887945",
    "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",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202530",
            "telephone_number": "562-598-7780",
            "fax_number": "562-598-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A. ROSENBERG, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-598-7780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G42241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G422411",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.