Provider Demographics
NPI:1528081064
Name:ROSENTHAL, STEPHEN MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MARTIN
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:559 E ALISAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2516
Mailing Address - Country:US
Mailing Address - Phone:831-769-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 200, SUITE 101
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-755-4124
Practice Address - Fax:831-759-6595
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG42045208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70126FMedicaid
CA94-6000524OtherCOUNTY OF MONTEREY EIN
CA94-6000524OtherCOUNTY OF MONTEREY EIN