Individual
DR. JON J ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
354 SANTA FE DR, ENCINITAS, CA 92024-5142
(760) 230-2251
(760) 230-2253
Mailing address
PO BOX 231189, ENCINITAS, CA 92023-1189
(760) 230-2251
(760) 230-2253
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C50622
CA
208M00000X
Hospitalist Physician
Primary
C50622
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000713416
AETNA
—
01
—
030471215
TRICARE
—
Enumeration date
10/05/2006
Last updated
11/14/2017
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