Individual
RAUL FERNANDO ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 S FAIR OAKS AVE STE 215, PASADENA, CA 91105-2613
(626) 793-4139
(626) 793-4324
Mailing address
PO BOX 80011, CITY OF INDUSTRY, CA 91716-8011
(626) 793-2885
(626) 793-6262
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G56414
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G564140
—
CA
Enumeration date
05/16/2006
Last updated
08/01/2024
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