Organization Active NPI

Siamak Rouzroch MD Inc

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1477741023
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SIAMAK ROUZROCH MD INC
Practice address
1703 Termino Ave
107
Long Beach, CA 90804-2124
Phone
(562) 494-8008
Fax
(562) 494-8001
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Siamak RouzrochNPI 1730271685
Title
MD
Phone
(562) 494-8008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1703 Termino Ave
107
Long Beach, CA 90804-2124

Mailing address

1703 Termino Ave
107
Long Beach, CA 90804-2124
Phone (562) 494-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000830 CA Part B Supplier - Clinic/Group Practice 0042100406 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Locations

1703 Termino Ave
Ste 107
Long Beach, CA 90804
Phone (562) 494-8008

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1477741023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 TERMINO AVE",
            "address_2": "107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042124",
            "telephone_number": "562-494-8008",
            "fax_number": "562-494-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 TERMINO AVE",
            "address_2": "107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042124",
            "telephone_number": "562-494-8008",
            "fax_number": "562-494-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIAMAK ROUZROCH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "ROUZROCH",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "562-494-8008"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.