Individual
MICHAEL BRIAN ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2615
(951) 782-3701
(951) 784-3262
Mailing address
3660 ARLINGTON AVE, RIVERSIDE, CA 92506-3912
(951) 782-5110
(951) 274-0403
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G39269
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ31887Z
GROUP SITE NUMBER
—
Enumeration date
11/30/2005
Last updated
03/01/2011
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