Organization
TRAUMA & CRITICAL CARE SFV GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY ROTH (PRESIDENT)
(818) 898-4900
Entity
Organization
Contact information
Practice address
11550 INDIAN HILLS ROAD, SUITE 310, MISSION HILLS, CA 91345
(818) 898-4900
Mailing address
11550 INDIAN HILLS ROAD, SUITE 310, MISSION HILLS, CA 91345
(818) 898-4900
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
G84133
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G84133
PRESIDENT MEDICAL LICENSE
CA
Enumeration date
07/26/2011
Last updated
07/26/2011
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