Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A143571 | CA |
NPI | 1104147172 |
---|---|
Provider Name | Dr. Gilbert Caluag Roc JR. |
First Address | Laguna Woods, CA 92637-2752 |
Second Address | Laguna Woods, CA 92637-2752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CB258349 | MEDICARE PTAN (01) | CA |