Provider Demographics
NPI:1548328941
Name:ROSENBERG, HOWARD L (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:L
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 BARLEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5232
Mailing Address - Country:US
Mailing Address - Phone:650-279-9463
Mailing Address - Fax:
Practice Address - Street 1:12300 BARLEY HILL RD
Practice Address - Street 2:
Practice Address - City:LOS ALTOS HILLS
Practice Address - State:CA
Practice Address - Zip Code:94024-5232
Practice Address - Country:US
Practice Address - Phone:650-279-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19113208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40527Medicare UPIN