Individual
MOHAMMAD ROOSTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 393-4000
(503) 681-1939
Mailing address
1234 SW 18TH AVE, PORTLAND, OR 97205-1752
(503) 681-1050
(503) 681-1939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A159854
CA
208M00000X
Hospitalist Physician
A159854
CA
208M00000X
Hospitalist Physician
Primary
MD211827
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2017
Last updated
04/17/2024
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