NPIMap

Organization Active NPI

Jack Rothberg MD a Medical Copt

  • Forensic Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1669740338
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
G29894 Issued in CA
Legal business name
JACK ROTHBERG MD A MEDICAL COPT
Practice address
6200 Wilshire Blvd
Suite 1612
Los Angeles, CA 90048
Phone
(323) 857-8000
Fax
(323) 857-8008
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Jack Rothberg, PHD, MDNPI 1043326911
Title
Owner
Phone
(323) 857-8000

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
Forensic Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084F0202X G29894 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd
Suite 1612
Los Angeles, CA 90048

Mailing address

6200 Wilshire Blvd
Suite 1612
Los Angeles, CA 90048
Phone (323) 857-8000

National Provider Directory

National Provider Directory

Locations

6200 Wilshire Blvd
Ste 1612
West Hollywood, CA 90048
Phone (310) 991-2989

Practitioners & affiliated clinicians

Practitioners 2

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": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1669740338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1612",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "323-857-8000",
            "fax_number": "323-857-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1612",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "323-857-8000",
            "fax_number": "323-857-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK ROTHBERG MD A MEDICAL COPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "ROTHBERG",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-857-8000",
        "authorized_official_credential": "PHD, MD"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "G29894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.