MEDICARE: DR. JOHN JOSEPH ROBERTS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A132586	CA

General Provider Information

NPI Number	:	1073584934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH ROBERTS M.D.

Provider Business Mailing Address
First Line	:	3153 AMBERWOOD LN
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92027-6505
Country	:	US
Telephone Number	:	760-315-6259
Fax Number	:

Provider Business Practice Location Address
First Line	:	3153 AMBERWOOD LN
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92027-6505
Country	:	US
Telephone Number	:	760-315-6259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	01/12/2016

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