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Individual

MICHAEL O ROACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15625 IMPERIAL HWY, LA MIRADA, CA 90638-1301
(562) 902-3000
(562) 902-9563
Mailing address
15625 IMPERIAL HWY, LA MIRADA, CA 90638-1627
(562) 902-3000
(562) 902-9563

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
G32190
CA
207R00000X
Internal Medicine Physician
G32190
CA

Other

Enumeration date
07/26/2006
Last updated
03/12/2012
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