MEDICARE: MR. ROUJIH TADROS NP

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	363LA2200X	Adult Health Nurse Practitioner	95180270	CA

General Provider Information

NPI Number	:	1154250793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROUJIH TADROS NP

Provider Business Mailing Address
First Line	:	17715 SWEETGUM LN
Second Line	:
City	:	CANYON COUNTRY
State	:	CA
Zip	:	91387-3825
Country	:	US
Telephone Number	:	661-753-7513
Fax Number	:

Provider Business Practice Location Address
First Line	:	17715 SWEETGUM LN
Second Line	:
City	:	CANYON COUNTRY
State	:	CA
Zip	:	91387-3825
Country	:	US
Telephone Number	:	661-753-7513
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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