| Johanna Rosenthal M.d. Inc. | |
|
1440 N Harbor Blvd Ste 900 Fullerton CA 92835-4122 | |
| (714) 449-3311 | |
| (714) 870-0002 |
| Full Name | Johanna Rosenthal M.d. Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1440 N Harbor Blvd Ste 900, Fullerton, California |
| Authorized Official Name and Position | Johanna Lynn Rosenthal (CEO) |
| Authorized Official Contact | 7142130492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Johanna Rosenthal M.d. Inc. 1440 N Harbor Blvd Ste 900 Fullerton CA 92835-4122 Ph: (714) 449-3311 | Johanna Rosenthal M.d. Inc. 1440 N Harbor Blvd Ste 900 Fullerton CA 92835-4122 Ph: (714) 449-3311 |
| NPI Number | 1881832251 |
|---|---|
| Provider Enumeration Date | 01/23/2009 |
| Last Update Date | 02/23/2022 |
| Certification Date | 02/23/2022 |
| Medicare PECOS PAC ID | 6002964608 |
|---|---|
| Medicare Enrollment ID | O20090509000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881832251 | NPI | - | NPPES |
| 00G409760 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G40976 (California) | Primary |
| Provider Name | Johanna L Rosenthal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881741247 PECOS PAC ID: 2769381318 Enrollment ID: I20040102000747 |
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