MEDICARE: OPERATION ROOFTOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1568333946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPERATION ROOFTOP

Provider Business Mailing Address
First Line	:	23 CORPORATE PLAZA DR STE 150-88
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7911
Country	:	US
Telephone Number	:	650-504-6379
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 CORPORATE PLAZA DR STE 150-88
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7911
Country	:	US
Telephone Number	:	650-504-6379
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LATOSHICA WILLIAMS
Credential	:
Telephone Number	:	650-504-6379

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

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Directions to “OPERATION ROOFTOP ” Practice Location

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