Michael M Roham, PA.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA15771 Issued in CA

Practice address

302 N El Camino Real Ste 112
San Clemente, CA 92672-4776

Phone

(949) 489-9898

Fax

(949) 489-2569

NPI assigned

Feb 2, 2011

Last updated

May 5, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Medical Concierge

  dba med-link

  • Psychiatric Residential Treatment Facility
  • San Clemente, CA
  • NPI 1790068971
  NPD Authorized official

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1043516404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 CAMINO DE LOS MARES",
            "address_2": "230",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732825",
            "telephone_number": "949-230-5343",
            "fax_number": "949-218-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N EL CAMINO REAL STE 112",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724776",
            "telephone_number": "949-489-9898",
            "fax_number": "949-489-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "647 Camino De Los Mares",
            "address_2": "suite 230",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926732825",
            "country_code": "US",
            "telephone_number": "949-218-4868",
            "fax_number": "949-218-4868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROHAM",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-02",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rodriguez-Pascual
• Jaqueline Rodriguez-Tapia
• Alisha Marie Rodriguez, DPT
• Sara Rodriguez
• Annalin Roepken
• Timothy O Roham, DO
• Lauren Michelle Rohrbaugh, MA, MFT
• Emmanuel Romero, LMFT
• Ronald Trosper DDS Inc
• Isabel Rosales, COTA/L

• Medical Physician Assistant in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.