MEDICARE: DR. THOMAS FRANKLIN ROE M.D.09

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	174400000X	Specialist	G8155	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124166392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS FRANKLIN ROE M.D.09

Provider Business Mailing Address
First Line	:	240 S CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3038
Country	:	US
Telephone Number	:	323-934-1691
Fax Number	:	323-934-1691

Provider Business Practice Location Address
First Line	:	240 S CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3038
Country	:	US
Telephone Number	:	323-934-1691
Fax Number	:	323-934-1691

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/08/2007

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