Individual
BRIAN CHARLES ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 EL CAMINO REAL, SUITE 160, BURLINGAME, CA 94010-3224
(650) 259-9480
(650) 259-1428
Mailing address
577 AIRPORT BLVD, SUITE 300, BURLINGAME, CA 94010-2020
(650) 240-8040
(650) 348-9060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G 035559
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G035559
MEDICAL LICENSE
CA
Enumeration date
08/14/2006
Last updated
07/08/2007
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