Provider Demographics
NPI:1174162283
Name:ROSEN MEDICAL GROUP INC
Entity type:Organization
Organization Name:ROSEN MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-799-4454
Mailing Address - Street 1:23621 PARK SORRENTO STE 102
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1395
Mailing Address - Country:US
Mailing Address - Phone:818-797-8000
Mailing Address - Fax:818-797-7799
Practice Address - Street 1:23621 PARK SORRENTO STE 102
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1395
Practice Address - Country:US
Practice Address - Phone:818-797-8000
Practice Address - Fax:818-797-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty