Organization
JACK ROTHBERG MD A MEDICAL COPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK ROTHBERG PHD, MD (OWNER)
(323) 857-8000
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD, SUITE 1612, LOS ANGELES, CA 90048
(323) 857-8000
(323) 857-8008
Mailing address
6200 WILSHIRE BLVD, SUITE 1612, LOS ANGELES, CA 90048
(323) 857-8000
(323) 857-8008
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
G29894
CA
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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