Healthcare Provider Details

I. General information

NPI: 1063309532
Provider Name (Legal Business Name): KRISTOFFER ROXAS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 MOLINO
IRVINE CA
92618-4832
US

IV. Provider business mailing address

5145 MOLINO
IRVINE CA
92618-4832
US

V. Phone/Fax

Practice location:
  • Phone: 949-316-8686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTOFFER ROXAS
Title or Position: OWNER
Credential: MD
Phone: 949-316-8686