Individual
ELDON KEITH ROSCOE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 SHALLOP ST, LAGUNA NIGUEL, CA 92677-4748
(949) 702-5832
Mailing address
2 SHALLOP ST, LAGUNA NIGUEL, CA 92677-4748
(949) 702-5832
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT22017
CA
Other
Enumeration date
09/29/2010
Last updated
11/26/2025
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