Individual
ROODABEH MICHELLE KOOLAEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 FAIRMOUNT AVE STE 210, PASADENA, CA 91105-3152
(808) 531-4274
(833) 438-1648
Mailing address
833 PARKMAN DR, LA CANADA, CA 91011-2547
(301) 602-0816
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS015491
PA
207RR0500X
Rheumatology Physician
Primary
20A12722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDI-CAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
07/16/2010
Last updated
10/24/2025
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