Tim Roham D.O. Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

29667 Issued in CA

Legal business name

TIM ROHAM D.O. INC

Practice address

629 Camino de Los Mares
Suite 103
San Clemente, CA 92673-2834

Phone

(949) 248-1900

Fax

(949) 248-1956

NPI assigned

Oct 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Omid Roham, D.O.

Title

Physician

Phone

(949) 248-1900

Specialties & licenses 1

Addresses

Other names 1

• Advance Laser & Cosmetic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carol Ann Barnes-Blanks, MD

  • Family Medicine Physician
  • Lake Forest, CA
  • NPI 1720009152
  NPD (past)
• Silvia Nicolae, MD

  • Anesthesiology Physician
  • San Clemente, CA
  • NPI 1245452937
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1124354592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES",
            "address_2": "SUITE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732834",
            "telephone_number": "949-248-1900",
            "fax_number": "949-248-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES",
            "address_2": "SUITE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732834",
            "telephone_number": "949-248-1900",
            "fax_number": "949-248-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM ROHAM D.O. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "ROHAM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "OMID",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "949-248-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "29667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Laser & Cosmetic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott G Thompson, ED.S, PPS
• Sean R Thompson, D.D.S.
• Thrifty Payless Inc
• Thrivelab Co.
• Wallace Thune, DDS
• Jenna K Timboe, MD
• Matthew Titus
• Tma Pathology Services
• Julie Kathleen Tobin, P T
• Talia Tomasin, PA-C

• All providers in San Clemente, CA
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.