Individual provider Active NPI

Paul William Rohdenburg, MD

  • Emergency Medicine Physician
  • Seal Beach, CA
National Provider Identifier
1730342064
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A110332 Issued in CA
Practice address
130 13TH St
Seal Beach, CA 90740-6531
Phone
(858) 361-3303
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A110332 CA Primary

Addresses

Primary practice location

130 13TH St
Seal Beach, CA 90740-6531

Mailing address

130 13TH St
Seal Beach, CA 90740-6531
Phone (858) 361-3303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000286 CA Practitioner - Emergency Medicine 1153502059 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A110332CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Emergency Medical Group Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients

Locations

3033 W Orange Ave
Anaheim, CA 92804
Phone (714) 229-5649

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1730342064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 13TH ST",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406531",
            "telephone_number": "858-361-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 13TH ST",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406531",
            "telephone_number": "858-361-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDENBURG",
        "first_name": "PAUL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A110332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

Verify at the official NPI Registry.