Healthcare Provider Details

I. General information

NPI: 1578777660
Provider Name (Legal Business Name): THOMAS ROCCAPALUMBO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6538 TELEGRAPH RD
COMMERCE CA
90040-2518
US

IV. Provider business mailing address

7300 ALONDRA BLVD STE 101
PARAMOUNT CA
90723-4000
US

V. Phone/Fax

Practice location:
  • Phone: 323-726-3212
  • Fax: 323-726-0942
Mailing address:
  • Phone: 562-531-8300
  • Fax: 562-531-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A5386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: