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Individual

DR. JAMES B ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2755 HERNDON AVE, CLOVIS, CA 93611-6800
(559) 935-5491
(559) 935-5719
Mailing address
9722 E SIERRA AVE, CLOVIS, CA 93619-9013
(559) 935-5491
(559) 935-5719

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20A4011
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX40110
CA
01
010000314
RAILROAD MEDICARE
CA
01
349152400
USDL
CA
Enumeration date
08/21/2006
Last updated
02/04/2020
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