MEDICARE: ROJAS MEDICAL GROUP INC

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	207R00000X	Internal Medicine Physician	A139535	CA

General Provider Information

NPI Number	:	1770091183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROJAS MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	2621 ZOE AVE FL 1
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4131
Country	:	US
Telephone Number	:	323-587-7000
Fax Number	:	323-587-8000

Provider Business Practice Location Address
First Line	:	2621 ZOE AVE FL 1
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4131
Country	:	US
Telephone Number	:	323-587-7000
Fax Number	:	323-587-8000

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALAN ROJAS
Credential	:	MD
Telephone Number	:	310-945-6751

Provider Enumeration Date	:	01/19/2018
Last Update Date	:	01/19/2018

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