Individual
DR. FREDERICK S ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1181 CENTRAL BLVD STE B, BRENTWOOD, CA 94513-2252
(925) 463-0336
(925) 463-1387
Mailing address
PO BOX 6177, ALAMEDA, CA 94501-6977
(925) 463-0336
(925) 463-1387
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A84955
CA
207YP0228X
Pediatric Otolaryngology Physician
Primary
A84955
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A84955
LICENSE
CA
01
—
ZZZ21406Z
MEDICARE GR
—
Enumeration date
10/13/2006
Last updated
03/19/2015
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