Individual provider Active NPI

Mark Magnus Rose, MD

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1780424861
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PTL20285 Issued in CA
Practice address
1050 Linden Ave
Long Beach, CA 90813-3321
Phone
(562) 491-9000
Fax
(562) 491-9146
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X PTL20285 CA Primary

Addresses

Primary practice location

1050 Linden Ave
Long Beach, CA 90813-3321

Mailing address

1050 Linden Ave
Long Beach, CA 90813-3321
Phone (562) 491-9000

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
I20251118004907 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921599804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PTL20285CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1780424861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133321",
            "telephone_number": "562-491-9000",
            "fax_number": "562-491-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133321",
            "telephone_number": "562-491-9000",
            "fax_number": "562-491-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARK",
        "middle_name": "MAGNUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "PTL20285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.