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Individual
DR. JON J ROTH
Active
Individual
DR. JON J ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C50622
CA
208M00000X
Hospitalist Physician
Primary
C50622
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000713416
AETNA
—
01
—
030471215
TRICARE
—
Enumeration date
10/05/2006
Last updated
11/14/2017
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