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General NPI Number Information
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NPI Number | 1942724778
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Entity Type | Organization
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Legal Business Name | ROCDOCS A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90017-4001
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Country | US
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Telephone | 310-882-3884
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Fax | 562-318-3048
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD STE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90017-4001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DEREK TAN DEE
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Credential | MD
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Telephone | 310-408-5345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A78281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A65423
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License Number State | CA
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