Healthcare Provider Details

I. General information

NPI: 1689610503
Provider Name (Legal Business Name): FILIP ROOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 KELLEY CT
LAFAYETTE CA
94549-4109
US

IV. Provider business mailing address

PO BOX 660877
SACRAMENTO CA
95866-0877
US

V. Phone/Fax

Practice location:
  • Phone: 916-481-0777
  • Fax: 916-481-1881
Mailing address:
  • Phone: 916-481-0777
  • Fax: 916-481-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA54519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: