Individual provider Active NPI

Norman Rosen, M.D

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1720085673
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G34431 Issued in CA
Practice address
1767 Glidden CT
San Diego, CA 92111-6921
Phone
(831) 595-6991
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G34431 CA Primary

Addresses

Primary practice location

1767 Glidden CT
San Diego, CA 92111-6921

Mailing address

1767 Glidden CT
San Diego, CA 92111-6921
Phone (831) 595-6991

Other identifiers 1

IdentifierTypeStateIssuer
010038860OtherCAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G34431CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB GYN Associates of the Central Coast Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1720085673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 GLIDDEN CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116921",
            "telephone_number": "831-595-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 GLIDDEN CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116921",
            "telephone_number": "831-595-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "NORMAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G34431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "010038860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.