| Doctor Name: | DR. MARK ELLIOT ROSEN |
| NPI Number: | 1942338009 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 20 A 4880 |
| Business Practice Address: | 4370 Alpine Rd Ste 205 Portola Valley, CA - 940287953 |
| Business Phone Number: | 6505290304 |
| Business Fax Number: | 6505291479 |
| Mailing Address: | 4370 Alpine Rd Ste 205, PORTOLA VALLEY |
| State: | CA |
| Postal Code: | 940287953 |
| Phone Number: | 6505290304 |
| Fax Number: | 6505291479 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 02/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 20 A 4880 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |