Provider Demographics
NPI:1538342464
Name:ROSENBERG, CAROL SUE (RN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:SUE
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3565 DEL AMO BLVD
Mailing Address - Street 2:DEPARTMENT OF ENDOCRINOLOGY
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1637
Mailing Address - Country:US
Mailing Address - Phone:310-214-0811
Mailing Address - Fax:310-793-9531
Practice Address - Street 1:3565 DEL AMO BLVD
Practice Address - Street 2:DEPARTMENT OF ENDOCRINOLOGY
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1637
Practice Address - Country:US
Practice Address - Phone:310-214-0811
Practice Address - Fax:310-793-9531
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA307042163WD0400X
CA177364S00000X, 364SC2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic Care