MICHAEL O ROACH (NPI# 1417970583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417970583 |
| Entity Type | Individual |
| Full Name | MICHAEL O ROACH |
| Credential | MD |
| Practice Address |
15625 Imperial Hwy La Mirada CA 90638-1301 |
| Mailing Address |
15625 Imperial Hwy La Mirada CA 90638-1627 |
| Practice Telephone | 5629023000 |
| Practice Fax Number | 5629029563 |
| Mailing Telephone | 5629023000 |
| Mailing Fax Number | 5629029563 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
G32190 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | G32190 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124523907 | Michael Justin Roach | Hearing Instrument Specialist | 4411 Old Bullard Rd Ste 501, Tyler, TX 75703-1215 | 2018-03-26 |
| 1063071694 | Michael Dean Roach | Hearing Instrument Specialist | 1400 Wsw Loop 323 Ste 100, Tyler, TX 75701-7201 | 2019-06-07 |
| 1114226735 | Michael Charles Roach | Radiology | 2226 Liliha St Ste B2, Honolulu, HI 96817-1605 | 2011-03-22 |
| 1235436791 | Michael Sp Roach | Nurse Practitioner | 325 W 20th St, Houston, TX 77008-2436 | 2011-02-18 |
| 1740592435 | Michael Dewayne Roach | Family Medicine | 686 Lester St, Poplar Bluff, MO 63901-5025 | 2010-07-09 |
| 1326256447 | Michael Stephen Roach | Physician Assistant | Us Naval Hospital Okinawa, Psc 482, Fpo, AP 96362-1600 | 2007-05-21 |
| 1689711665 | Michael P Roach | Optometrist | 1001 Sturdy Rd, Valparaiso, IN 46383-4126 | 2007-01-31 |
| 1528004389 | Michael L Roach | Family Medicine | 315 E Elm St, Suite 100, Caldwell, ID 83605-4857 | 2006-06-21 |
| 1487697801 | Michael Roach | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1001 Blythe Blvd, Ste 300 - Thoracic Surgery, Charlotte, NC 28203-5866 | 2006-06-14 |
| 1003863309 | Michael Roach | Social Worker | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2006-05-30 |
| Street Address |
15625 IMPERIAL HWY |
| City | LA MIRADA |
| State | CA |
| Zip Code | 90638-1301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598893455 | Imperial Primary Care Medical Group | Internal Medicine | 15625 Imperial Hwy, La Mirada, CA 90638 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972144095 | Amanda Connell | Counselor | 13710 La Mirada Blvd., Straight Talk, La Mirada, CA 90638 | 2019-09-30 |
| 1679054894 | James Kim | Occupational Therapist | 11926 La Mirada Blvd., La Mirada, CA 90638 | 2018-08-25 |
| 1780163915 | Complete Spine and Joint Center Inc | Chiropractor | 15112 Rosecrans Ave, La Mirada, CA 90638 | 2018-08-08 |
| 1124520606 | Meredith Narcisse | Counselor | Aegis Treatment Center 14240 Imperial Hwy, La Mirida, CA 90638 | 2018-03-01 |
| 1336685114 | Dorina Hamilton | Counselor | 14240 E. Imperial Hwy., La Mirada, CA 90638 | 2017-01-17 |
| 1497201768 | Blm Pharmacy Inc | Pharmacy | 12675 La Mirada Blvd., Suite 100, La Mirada, CA 90638 | 2016-08-28 |
| 1972954535 | Wendy Tran | Dentist | 12265 La Mirada Blvd, La Mirada, CA 90638 | 2016-06-24 |
| 1962851410 | Amy Bender | Counselor | 14240 Imperial Highway, La Mirada, CA 90638 | 2016-06-06 |
| 1699137430 | Andrea Lauren Smith | Chiropractor | 15651 East Imperial Hwy Ste 100, La Mirada, CA 90638 | 2016-03-22 |
| 1750797098 | Napoleon Tiquia | General Practice | 12049 Hartdale Avenue, La Mirada, CA 90638 | 2014-07-08 |
| Find all providers in zip 90638 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
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|---|---|---|---|---|
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| 1225657331 | Samantha Lillian Escalera | Family Medicine | 9608 Planter St, Pico Rivera, CA 90660-4743 | 2020-04-09 |
| 1164058897 | Amani A Osman | Family Medicine | 9753 Holder St, Cypress, CA 90630-4004 | 2020-03-13 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1013549914 | Vertini Medical Group Inc | Family Medicine | 1001 W Carson St Ste S, Torrance, CA 90502-2051 | 2020-02-07 |
| 1295297463 | Cedars Family Medicine Inc | Family Medicine | 18021 Sky Park Cir Ste G, Irvine, CA 92614-6569 | 2019-04-04 |
| 1811455967 | Hope Geriatric Medical Center Inc | Family Medicine | 9 Coursan, Laguna Niguel, CA 92677-8902 | 2019-03-07 |
| 1245702174 | Jonah Medical Group Inc | Family Medicine | 20627 Golden Springs Dr Ste D, Walnut, CA 91789-4814 | 2018-12-17 |
| 1104392885 | Wilshire Connected Care | Family Medicine | 277 South St Ste S, San Luis Obispo, CA 93401-5039 | 2018-10-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.