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Individual

JAMES JOSEPH ROACH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
201 S. BUENA VISTA ST., SUITE 440, BURBANK, CA 91505
(818) 842-4819
(818) 842-2086
Mailing address
201 S. BUENA VISTA ST., SUITE 440, BURBANK, CA 91505
(818) 842-4819
(818) 842-2086

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
G35197
CA
207RP1001X
Pulmonary Disease Physician
Primary
G35197
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
290003061
PTAN (RAILROAD MCARE)
05
ZZZ77466Z
CA
Enumeration date
02/23/2006
Last updated
03/04/2010
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