Healthcare Provider Details

I. General information

NPI: 1497745772
Provider Name (Legal Business Name): ROLANDO F. ROBERTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST ACC #3800
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST ACC #3800
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6234
  • Fax: 916-734-7904
Mailing address:
  • Phone: 916-734-6234
  • Fax: 916-734-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG868700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: