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NPI Code Detail

MEDICARE: DR. ROSHAN REPORTER MD, MPH

MEDICARE:  DR. ROSHAN  REPORTER  MD, MPH
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
12083P0901XPublic Health & General Preventive Medicine PhysicianG61330CA

General Provider Information

NPI Number : 1497924096
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSHAN REPORTER MD, MPH
Provider Business Mailing Address
First Line : 313 N FIGUEROA ST
Second Line : ROOM 212
City : LOS ANGELES
State : CA
Zip : 90012-2602
Country : US
Telephone Number : 213-240-7941
Fax Number : 213-482-4856
Provider Business Practice Location Address
First Line : 313 N FIGUEROA ST
Second Line : ROOM 212
City : LOS ANGELES
State : CA
Zip : 90012-2602
Country : US
Telephone Number : 213-240-7941
Fax Number : 213-482-4856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 02/27/2008

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Directions to “ DR. ROSHAN REPORTER MD, MPH” Practice Location

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