Gustavo Toshio Roldan, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 19149 Issued in CA

Practice address

3942 Maine Ave
Baldwin Park, CA 91706-4220

Phone

(626) 678-9296

Fax

(626) 678-9294

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Proyecto del Barrio IncGroup PAC ID 3476546227, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Azusa, CA
  • NPI 1770696023
  Medicare reassignment Care Compare group
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Northridge, CA
  • NPI 1093181448
  NPD
• El Proyecto del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • Panorama City, CA
  • NPI 1568871143
  NPD

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1699985705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3942 MAINE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064220",
            "telephone_number": "626-678-9296",
            "fax_number": "626-678-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3942 MAINE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064220",
            "telephone_number": "626-678-9296",
            "fax_number": "626-678-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "GUSTAVO",
        "middle_name": "TOSHIO",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 19149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denice Rodriguez, B.A
• Libby Rodriguez, NP
• Martha Livier Rodriguez
• Ray Rodriguez, MD
• John David Rojas, PHARM.D.
• Romero Chiropractic Inc
• Laura Romero, CNM
• Rosalina See-Prats, M.D. a Medical Corporation
• Michelle Yvonne Rose, PHARM.D.
• Sherry Rostami, DC

• Physician Assistant in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.