Provider Demographics
NPI:1962711713
Name:SAUL ROSOFF, MD INC
Entity type:Organization
Organization Name:SAUL ROSOFF, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-277-8900
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE #1209
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-277-8900
Mailing Address - Fax:310-286-7124
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE #1209
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-277-8900
Practice Address - Fax:310-286-7124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31898261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care