DR. FREDRIC ROBERT ROSENBERG (NPI# 1295885630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295885630 |
| Entity Type | Individual |
| Full Name | DR. FREDRIC ROBERT ROSENBERG |
| Credential | M.D. |
| Practice Address |
3650 E. South Street #306 Lakewood CA 90712 |
| Practice Telephone | 3103781915 |
| Practice Fax Number | 3103786979 |
| Mailing Telephone | 3103781915 |
| Mailing Fax Number | 3103786979 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2010-10-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | G21402 | CA | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
G21402 | CA | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
G21402 | CA | Allopathic & Osteopathic Physicians |
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
G21402 | CA | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
G21402 | CA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
G21402 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G214020 | 05 | |
| CA | BLUE SHIELD | ZZZ12556Z | 01 |
| CA | STATE LICENSE | G21402 | 01 |
| CA | AETNA | 4024334 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801219373 | Fredric Kevin Rosenberg | Preventive Medicine | 3270 Cochise Dr Se, Atlanta, GA 30339-4319 | 2014-02-03 |
| Street Address |
3650 E. SOUTH STREET #306 |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689289944 | Createwellness LLC | Social Worker | 5250 Hayter Avenue, Lakewood, CA 90712 | 2020-09-14 |
| 1801451398 | Marilou Toquero Dental Corp | Durable Medical Equipment & Medical Supplies | 3203 Carson St Suite 2, Lakewood, CA 90712 | 2019-05-09 |
| 1225510126 | N Ozder Dental Practice Inc | Clinic/Center | 5037 Lakewood Blvd, Lakewood, CA 90712 | 2018-09-06 |
| 1003394446 | Robert Michael Schlesinger | Counselor | 5150 Candlewood St Ste 13a, Lakewood, CA 90712 | 2018-07-28 |
| 1316439847 | P.r.i.s.m. Institute Inc. | Chiropractor | 5233 Premiere Ave, Lakewood, CA 90712 | 2018-05-31 |
| 1316477938 | Broadleaf Healthcare | Orthotist | 4345 Levelside Ave, Lakewood, CA 90712 | 2017-06-15 |
| 1679008049 | Adrienne Yoshiko Doi | Podiatrist | 3700 East South Street, Lakewood, CA 90712 | 2017-04-24 |
| 1841747334 | Garrison R Weaver-gourdeau | Chiropractor | 4115 E. South St, Lakewood, CA 90712 | 2016-09-01 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1841657251 | Roxanna Jimenez | Rehabilitation Practitioner | 5818 Clark Ave, Lakewood, CA 90712 | 2016-01-15 |
| Find all providers in zip 90712 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396864500 | Alpine Dermatology Associates Pllc | Dermatology | 1785 Kipling St, Lakewood, CO 80215-2843 | 2007-03-28 |
| 1801971098 | Darnell L Martin-wimmer | Dermatology | 1785 Kipling, Lakewood, CO 80215 | 2006-10-26 |
| 1467566208 | Emanuel G Kuflik | Dermatology | 150 E Kennedy Blvd, Lakewood, NJ 08701-1345 | 2006-08-18 |
| 1023044724 | Advanced Dermatology & Skin Surgery, PC | Dermatology | 886 River Ave, Lakewood, NJ 08701-5220 | 2006-06-24 |
| 1497703185 | Kira Rand Giovanielli | Dermatology | 3455 S Yarrow St, Lakewood, CO 80227-5031 | 2006-05-04 |
| 1992762017 | Mordechai M Tarlow | Dermatology | 456 Chestnut St, Suite 201, Lakewood, NJ 08701-6124 | 2006-05-01 |
| 1275933780 | Lakewood Dermatology | Dermatology | 14701 Detroit Ave, Suite 208, Lakewood, OH 44107-4115 | 2014-09-03 |
| 1760749683 | Lisa Ann Blackwood | Dermatology | 3455 S Yarrow St, Lakewood, CO 80227 | 2012-04-17 |
| 1093848509 | Prohealth Partners, A Medical Group | Dermatology | 5750 Downey Ave, Suite 100, Lakewood, CA 90712-1405 | 2007-03-13 |
| 1154407856 | Advanced Dermatology Surgical and Medical Group Inc. | Dermatology | 3650 E South St, #306, Lakewood, CA 90712 | 2006-10-27 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.