Rosenberg, Jack A.

Rosenberg, Jack A. is an sole proprietor health care provider with primary practice located at 5920 N. E. Ray Circle Suite 220, Hillsboro OR 97124-6313. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Adolescent Medicine is his primary health care specialty. Rosenberg, Jack A. can be contacted via phone (503) 690-0707.

Contact Information

Primary practice address
5920 N. E. Ray Circle Suite 220 Hillsboro OR 97124-6313
Phone: (503) 690-0707
Fax: (503) 690-9796
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD08402 Oregon
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MD08402 Oregon
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X MD08402 Oregon

Profile Details

NPI number 1790748556
LBN Legal business name Rosenberg, Jack A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2006
Last updated Apr 28th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790748556 NPPES
Oregon MEDICAID 164012

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