MEDICARE: DR. JOHN W ROARK JR. MD

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	207RG0100X	Gastroenterology Physician	G038581	CA

General Provider Information

NPI Number	:	1609834266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN W ROARK JR. MD

Provider Business Mailing Address
First Line	:	3741 LINWOOD AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-1711
Country	:	US
Telephone Number	:	510-589-8774
Fax Number	:

Provider Business Practice Location Address
First Line	:	3741 LINWOOD AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94602-1711
Country	:	US
Telephone Number	:	510-589-8774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	02/10/2026

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