Michael O Roach, MD | |
15625 Imperial Hwy, La Mirada, CA 90638-1301 | |
(562) 902-3000 | |
(562) 902-9563 |
Full Name | Michael O Roach |
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Gender | Male |
Speciality | Family Medicine - Geriatric Medicine |
Location | 15625 Imperial Hwy, La Mirada, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417970583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QG0300X | Family Medicine - Geriatric Medicine | G32190 (California) | Primary |
207R00000X | Internal Medicine | G32190 (California) | Secondary |
Entity Name | Imperial Primary Care Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598893455 PECOS PAC ID: 3476528316 Enrollment ID: O20040901001416 |
Mailing Address | Practice Location Address |
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Michael O Roach, MD 15625 Imperial Hwy, La Mirada, CA 90638-1627 Ph: (562) 902-3000 | Michael O Roach, MD 15625 Imperial Hwy, La Mirada, CA 90638-1301 Ph: (562) 902-3000 |
Marcus Wesley Lum, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15034 Imperial Hwy, La Mirada, CA 90638 Phone: 562-902-3000 Fax: 562-902-9563 | |
Alexander A Mendez, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 12675 La Mirada Blvd, Suite 201, La Mirada, CA 90638 Phone: 562-903-7339 Fax: 562-944-8631 | |
Rafael Rubalcava, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15034 Imperial Hwy, La Mirada, CA 90638 Phone: 562-902-3000 Fax: 562-902-9563 | |
Anthony Reyes Jr., M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 12675 La Mirada Blvd, Suite 201, La Mirada, CA 90638 Phone: 562-903-7339 Fax: 562-944-8631 | |
Dr. Joseph Ravenna Jr., M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 15651 Imperial Hwy, Suite 101, La Mirada, CA 90638 Phone: 562-943-6715 Fax: 562-943-2665 | |
Gregory John Galbreath, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 12675 La Mirada Blvd Ste 201, La Mirada, CA 90638 Phone: 562-903-7339 |