Larry K. Rosebraugh, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10166 Issued in CA

Practice address

501 S Buena Vista St
Burbank, CA 91505-4809

Phone

(818) 843-5111

Fax

(405) 749-4561

NPI assigned

Jun 7, 2006

Last updated

Mar 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Northridge Emergency Medical Group

  • Emergency Medicine Physician
  • Northridge, CA
  • NPI 1093771222
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1811937105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80116",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168116",
            "telephone_number": "800-749-4560",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054809",
            "telephone_number": "818-843-5111",
            "fax_number": "405-749-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBRAUGH",
        "first_name": "LARRY",
        "middle_name": "K.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA10166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA10166 APPROVED",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Rosania, MS
• Rose Healing Retreat
• Rose Valley Hospice, Inc.
• Anjelica Rose
• Christopher M Rose, M.D.
• Roseline Dauphin Baptiste MD Inc
• Gilbert Neil Ross, MD
• Kaitlyn Ross, PHARMD
• Kenneth Michael Ross, D.D.S.
• Meredith Rossi

• Physician Assistant in Burbank, CA
• Providers in Burbank, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.