Organization Active NPI

Rosenberg Plastic Surgery, P.C.

  • Plastic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1689852865
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A92453 Issued in CA
Legal business name
ROSENBERG PLASTIC SURGERY, P.C.
Practice address
1820 S Beverly Glen Blvd
#205
Los Angeles, CA 90025-6927
Phone
(312) 213-1974
Fax
(310) 278-0098
NPI assigned
Feb 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Authorized official

Name
Dr. David Samuel Rosenberg, M.D.NPI 1770618548
Title
Senior Partner
Phone
(312) 213-1974

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
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X A92453 CA Primary

Addresses

Primary practice location

1820 S Beverly Glen Blvd
#205
Los Angeles, CA 90025-6927

Mailing address

1820 S Beverly Glen Blvd
#205
Los Angeles, CA 90025-6927
Phone (312) 213-1974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000221 CA Part B Supplier - Clinic/Group Practice 5698845121 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory

Locations

11301 W Olympic Blvd
Ste 1
Los Angeles, CA 90064

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": "1202515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1689852865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 S BEVERLY GLEN BLVD",
            "address_2": "#205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256927",
            "telephone_number": "312-213-1974",
            "fax_number": "310-278-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 S BEVERLY GLEN BLVD",
            "address_2": "#205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256927",
            "telephone_number": "312-213-1974",
            "fax_number": "310-278-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSENBERG PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-09",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "312-213-1974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A92453",
            "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 Aug 14, 2008; 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.