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:
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Health care specialties

SpecialtyCodeLicense #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 16 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 1730100124 NPPES
California Other 953053865 TRICARE
California MEDICAID ZZZ76011Z TRICARE

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