Healthcare Provider Details

I. General information

NPI: 1235054610
Provider Name (Legal Business Name): DAVID ROCHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 VISTA WAY
OCEANSIDE CA
92054-5663
US

IV. Provider business mailing address

2335 VISTA WAY
OCEANSIDE CA
92054-5663
US

V. Phone/Fax

Practice location:
  • Phone: 760-547-2666
  • Fax:
Mailing address:
  • Phone: 760-547-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number55106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: