Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G11992 | CA |
NPI | 1043388267 |
---|---|
Provider Name | Albert E Roller |
First Address | Salinas, CA 93901-3916 |
Second Address | Salinas, CA 93901-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G119920 | (05) | CA |
A38509 | (02) | CA |