Provider Demographics
NPI:1306980693
Name:ROTMAN, MADELEINE E (PA-C)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:E
Last Name:ROTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13910
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92255-3910
Mailing Address - Country:US
Mailing Address - Phone:760-347-1233
Mailing Address - Fax:760-775-0776
Practice Address - Street 1:81880 DOCTOR CARREON BLVD
Practice Address - Street 2:C104
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5559
Practice Address - Country:US
Practice Address - Phone:760-347-1233
Practice Address - Fax:760-775-0776
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical