Rotenberg, Jack Stuart
Rotenberg, Jack Stuart is an individual health care provider with primary practice located at 2241 Wankel Way Ste. A., Oxnard CA 93030-0190. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Rotenberg, Jack Stuart can be contacted via phone (805) 983-0521.Contact Information
Primary practice address
2241 Wankel Way Ste. A.
Oxnard CA 93030-0190
Phone: (805) 983-0521
Fax: (805) 983-4186
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | A24099 | California |
Profile Details
NPI number | 1730100124 |
---|---|
LBN Legal business name | Rotenberg, Jack Stuart |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 21st, 2006 |
Last updated | Mar 15th, 2010 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1730100124 | NPPES |
California | Other | 953053865 | TRICARE |
California | MEDICAID | ZZZ76011Z | TRICARE |
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