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Individual

GUSTAVO MARIO ROLDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
3221 LIBERTY BLVD, SOUTH GATE, CA 90280-2315
(323) 566-9171
(323) 566-9178
Mailing address
3221 LIBERTY BLVD, SOUTH GATE, CA 90280-2315
(323) 566-9171
(323) 566-9178

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17277
CA

Other

Enumeration date
06/18/2006
Last updated
07/08/2007
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