Individual provider Active NPI

Rachel Junhn Roan, MD

  • Nephrology Physician
  • Wildomar, CA
National Provider Identifier
1003496894
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A192091 Issued in CA
Practice address
36320 Inland Valley Dr Ste 307
Wildomar, CA 92595-7512
Phone
(951) 687-3400
Fax
(951) 687-7630
NPI assigned
Apr 14, 2021
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A192091 CA Primary

Addresses

Primary practice location

36320 Inland Valley Dr Ste 307
Wildomar, CA 92595-7512

Mailing address

3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071
Phone (951) 687-3400

Other practice location 1

425 Diamond Dr Ste 102
Lake Elsinore, CA 92530-4495
Phone (951) 687-7140

Other practice location 2

31537 Rancho Pueblo Rd Ste 201
Temecula, CA 92592-4841
Phone (951) 687-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618001684 CA Practitioner - NephrologyPractitioner - Internal Medicine 7810339611

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3660 Park Sierra Dr
Suite 203
Riverside, CA 92505-3071

4459 E Pepper Creek Way
Anaheim, CA 92807-3552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A192091CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Medical Group Inc Nephrology PastSince May 22, 2022 Accepting new patients
Alertive Healthcare Medical Group PC PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1003496894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR STE 307",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Diamond Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925304495",
            "country_code": "US",
            "telephone_number": "951-687-7140",
            "fax_number": "951-303-3565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31537 Rancho Pueblo Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925924841",
            "country_code": "US",
            "telephone_number": "951-687-7140",
            "fax_number": "951-303-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROAN",
        "first_name": "RACHEL",
        "middle_name": "JUNHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A192091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.