Provider Demographics
NPI:1902432982
Name:ROSENBAUM, MADISON (MS, ATC, NASM-CPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:MS, ATC, NASM-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 INDIAN PIPE
Mailing Address - Street 2:
Mailing Address - City:DOVE CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-4206
Mailing Address - Country:US
Mailing Address - Phone:949-683-3450
Mailing Address - Fax:
Practice Address - Street 1:1 TESORO CREEK RD
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-6503
Practice Address - Country:US
Practice Address - Phone:949-234-5310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-21
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer