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JACK STUART ROTENBERG MD NPI 1730100124


NPI Profile

NPI: 1730100124
Provider Name: JACK STUART ROTENBERG, MD
Classification:Internal Medicine - 207RG0100X
Entity Type: Individual

Specialization: Gastroenterology

PECOS Registration: Yes

Address:
2241 WANKEL WAY
STE. A.
OXNARD, CA
ZIP 93030
Get Directions

Phone: (805) 983-0521

Jack Stuart Rotenberg, MD is a gastroenterology internal medicine in Oxnard, CA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Jack Stuart Rotenberg, MD NPI is 1730100124. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2241 WANKEL WAY
STE. A.
OXNARD, CA
ZIP 93030-190
Phone: (805) 983-0521
Fax: (805) 983-4186

The NPI 1730100124 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 3/15/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0100XInternal MedicineGastroenterologyA24099CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W2289MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2ZZZ76011ZMEDICAIDCALIFORNIA
3A24099MEDICARE UPINCALIFORNIA
4953053865OTHERCALIFORNIATRICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 10/10/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.